A textbook in the Illustrated Colour Text series on ENT, aimed at medical students and junior doctors. Concise presentation of ENT in the attractive ICT format - clear line diagrams, colour photos of clinical conditions, summary boxes etc. Covers a topic which is important in primary care - medical students and junior doctors are motivated to buy a book in this area. Basic anatomy and physiology is reviewed - useful revision for students in clinical years. Comprehensive coverage of both presenting symptoms and specific diseases, with more detail on the commoner conditions. Clear description of examination and investigation techniques.

Ear reconstruction is required in a variety of patients, including especially those with congenital anomalies and associated deformities. In this book, a renowned practitioner in ear reconstruction explains the approaches that he has personally developed over the past 40 years in order to improve surgical results and also presents important new concepts. The proposed techniques offer tailored solutions to specific problems and are applicable in settings including severe microtia, moderate microtia, anotia, traumatic amputation, and unsatisfactory prominent ear surgery. Complications during and after ear reconstruction are also discussed, with guidance on their treatment. Throughout the book, the aim of the author is to share the fruits of his extensive experience with fellow surgeons in an informative and practically oriented way. The clearly written text is complemented by numerous helpful color photographs.

The contemporary context of young adulthood. The contemporary context of young adulthood in the USA : from demography to development, from private troubles to public issues / Richard A. Settersten Jr. ; Transition to adulthood, parental support, and early adult well-being : recent findings from the youth development study / Jeylan T. Mortimer ; "First principles" : components, holism, and context of the transition to adulthood / Ross Macmillan ; Young adults in a wireless world / Eva S. Lefkowitz, Shelley N. Vukman, and Eric Loken -- Parent-child relationships and successful transitions. Relationships between young adults and their parents / Karen L. Fingerman ... [et al.] ; The implications of family context for the transition to adulthood / Monica Kirkpatrick Johnson and Janel Benson ; Child well-being and the long reach of family relationships / Kelly Musick and Ann Meier ; Young adults' "need" : in the eye of the beholder? / D. Wayne Osgood and Sonja E. Siennick -- Romantic and sexual relationships. Developmental shifts in the character of romantic and sexual relationships from adolescence to young adulthood / Peggy C. Giordano .. [et al.] ; Challenges in charting the course of romantic relationships in adolescence and emerging adulthood / Frank D. Fincham ; I just want your kiss? : sexual relationships in young adulthood / Kelly Raley -- Family contexts and timing of fertility. Becoming a parent : the social contexts of fertility during young adulthood / Kathryn Edin and Laura Tach ; Childbearing among cohabiting women : race, pregnancy, and union transitions / Daniel T. Lichter ; Understanding young fertility in the context of economic disadvantage / Marcia J. Carlson -- The study of young adulthood. New horizons in research on emerging and young adulthood / Jeffrey Jensen Arnett ; The role of family context in early adulthood : where we've been and where we're going / Jessica Halliday Hardie and Christine E. Stanik.

More than 40 articles provide an extensive coverage of advances over the last three years of research on subarachnoid hemorrhage-induced brain injuries and cerebral vasospasm. Early brain injury, the new frontier of subarachnoid hemorrhage research, which may be a key contributor to the high mortality and morbidity, promotes collaborative efforts from neurosurgery, neurology, neuro-ICU into other interrelated fields and basic neurosciences. For the first time, subarachnoid hemorrhage research is almost equally divided by early brain injury and cerebral vasospasm, mechanistic investigations and therapeutic approaches, demonstrating a translational feature of the future direction.

Preliminaries -- Overview. Early detection of psychosis: state of the art and future perspectives -- Early intervention in emerging psychosis: state of the art and future perspectives -- Early detection of psychosis: clinical assessments. First signs of emerging psychosis -- Psychosis high-risk states in adolescents -- The psychosis high-risk state -- Early detection of psychosis: helpful or stigmatizing experience for those concerned? -- Early detection of psychosis: neuroimaging. Structural and functional MRI in the prediction of psychosis -- Pattern recognition methods in the prediction of psychosis -- Connectivity abnormalities in emerging psychosis -- Early detection of psychosis: neurocognitive and neurophysiological assessments. Neurocognition and motor functioning in the prediction of psychosis -- Electroencephalographic predictors of psychosis -- Early intervention in emerging psychosis. Psychological methods of early intervention in emerging psychosis -- Nonpharmalogical substances for early intervention -- Pharmacological intervention in first-episode psychosis -- Conclusions and future perspectives. early detection and intervention in psychosis.

"This Recent Results in Cancer Research volume provides an up-to-date overview of the multidisciplinary management of locally confined rectal cancer as well as colorectal cancer with synchronous resectable liver metastases. The contents comprise the majority of the invited contributions from the Second St. Gallen EORTC Gastrointestinal Cancer Conference, held on 6-8 March 2014 in St. Gallen, Switzerland. Written by some of the world's leading experts in the imaging, endoscopy, pathology, molecular biology, surgery, radiotherapy, and medical oncology of rectal cancer and liver metastases, the chapters offer a comprehensive view on the latest recommendations in diagnosis and multidisciplinary treatment. Every clinician involved in the care of patients with rectal cancer will find this book interesting and helpful."--Publisher's description.

Machine generated contents note: List of contributors -- Foreword -- Part I: The Rationale for Early Intervention in Nearly Everything -- 1 Introduction -- 2 How Early Intervention can turn things upside down and turn a patient into a psychiatrist -- 3 Involving the Family in Early Interventions -- 4 Do Early Intervention Services for Psychosis Represent Value for Money? -- Part II: Early Intervention across the Lifespan -- 5 Perinatal preventive interventions in psychiatry: A clinical perspective -- 6 Psychiatry and Intervention in Infancy and Early Childhood -- 7 Early Intervention for young people with mental illness -- 8 Transiting out of Child and Adolescent Mental Health Services -- 9 Adults of working age -- 10 Early Intervention in Older Adults -- A focus on Alzheimer's Dementia -- Part III: Early Intervention in Specific Settings -- 11 Primary prevention of mental disorders -- 12 Early intervention in mental health problems: the role of the voluntary sector -- 13 Why primary care matters for early intervention in psychiatry -- 14 General hospitals -- 15 Early Intervention Services: Background, rationale and development -- Part IV: Early Intervention in Specific Disorders -- 16 Prevention and early intervention in depression and anxiety disorders -- 17 Alcohol and substance use prevention and early intervention -- 18 Early intervention in childhood disorders -- 19 Early intervention for Delirium -- 20 Early intervention for Self-harm -- 21 Early intervention in Bipolar disorder -- 22 Early intervention in Eating disorders -- 23 Early intervention to reduce violence and offending outcomes in young people with mental disorders -- 24 Early intervention for Borderline Personality Disorder -- Part V: Conclusions -- 25 Early intervention and The Power of Social Movements: UK development of early intervention in psychosis as a social movement and its implications for leadership -- 26 Challenging stigma -- 27 Conclusions including standards -- Afterword.

What is the EU infant nutrition cluster? -- Early nutrition and its later consequences: new opportunities -- The developmental origins of adult health and well-being -- Long term effects of breastfeeding on the infant and mother -- Experimental evidence for long-term programming effects of early diet -- Candidate genes for obesity--how might they interact with environment and diet? -- Rate of growth in early life: a predictor of later health? -- Protective effect of breast-feeding against obesity in childhood-- Discussion forum: from innovation to implementation -- Challenges and opportunities in pan-European collaboration for researchers from Central and Eastern Europe -- Best practice in communicating the results of European research to the public -- Longterm effects of pre- and postnatal exposure to low and high dietary protein levels / Cornelia C. Metges -- Protein intake in the first year of life: a risk factor for later obesity? -- The role of long-chain poly-unsaturated fatty acids (LCPUFA) in growth and development -- Experimental models for studying perinatal lipid metabolism -- Effect of N-3 polyunsaturated fatty acid supplementation in pregnancy: the Nuheal trial -- Young researchers' workshop -- Consumer needs regarding dietetic products for pregnant and lactating women and for baby foods -- Focus group: breakfast meeting: SMES and their co-operation with academia -- Ethical issues in perinatal nutrition research -- Early programming of diabetes risk--an introduction -- Early nutrition and later diabetes risk -- Is type 1 diabetes a disease of the gut immune system triggered by cow's milk insulin? -- Gluten-free diet in subjects at risk for type 1 diabetes: a tool for delaying progression to clinical disease? -- Insulin like growth factor regulation of body mass in breastfed and milk formula fed infants -- Inverse association between trans isomeric and long-chain polyunsaturated fatty acids in erythrocyte membrane lipids in pregnant women -- Comparison of essential fatty acid status among German, Hungarian and Spanish women at mid-gestation -- Trans isomeric fatty acids as confounding variables in studies on perinatal LC-PUFA supply -- An eight years prospective study of iron deficiency anaemia in infancy -- New insights in the potential mechanism of action of nucleotides to modulate immunity -- Thriving of malnourished breastfed infants after additional formula milk feeding -- Role of mammary gland lipoprotein lipase in the availablilty of polyunsaturated fatty acids for milk synthesis -- Is the crying behaviour in infants up to the age of 3 months influenced by the type of early nutrition? -- Dietary gangliosides: beneficial effects for the neonate and potential mechanism of action -- Leptin in breast-fed and formula-fed infants -- Dietary fatty acids during pregnancy determines maternal fatty acid profile during late pregnancy and their availability to the fetus even during fasting condtions -- Effects of oil-supplemented diets on liver expression of PPAR alpha-related genes in pregnant rats -- Effect of a new infant formula enriched with prebiotics, probiotics, nucleotides and LC-PuFA on recovery after infection -- Does habitual protein intake in early childhood influence age and body mass index at adiposity rebound? -- Dietary compliance in diabetes prevention project in Finland -- Changes of plasma fatty acid profile and antioxidant vitamins during normal pregnancy -- Optimal design for the recruitment of participants as a factor for the effective implementation of a clinical trial -- The effect of ponderal index on plasma concentration of insulin-like growth factor-1 (IGF-1) in neonatal pigs -- Effects of prenatal exposure to low and high dietary protein levels on maternal and fetal amino acid metabolism in rats -- Cow's milk introduction in Spanish infants -- Longer term effects of early cholesterol intake on cholesterol biosynthesis and plasma lipids: a randomized clinical trial -- Patterns of growth and energy utilization of the diet after a period of dietary restriction during the weaning period -- Infant formula feeding pattern and weaning introduction in Spanish infants -- Visual evoked potentials in infants after dietary supply of docosahexaenoic acid and 5-methyltetrahydrofolate during pregnancy -- Electronic data capture and use of internet technologies in a double-blind randomised intervention trial -- Breastfeeding and baby friendly hospital initiative in Slovenia -- Nutritional status in young adults with screen-detected silent/sub-clinical coeliac disease -- Liporotein lipase (LPL) MRNA expression in placentas from normal and IUGR (intrauterine growth restricted) pregnancies by real-time PCR -- Maternal fasting effect on neonatal health -- The quality of schoolchildren's nutrition in Serbia -- Tendency towards obesity in Sydney school children -- Monitoring and supervising a dietary intervention trial using modern data processing system -- Analysis of drop-outs in a longitudinal study -- Recruitment strategies of the Spanish group in the "EU childhood obesity: programming by infant nutrition" -- Diet and nutritional risk factors in schoolchildren -- Influence of two forms of caseinophosphopeptide on iron bio availability -- Model of childhood obesity primary prevention programme -- Problems related to recruitment of participants for the triger project -- Vitamin D status at birth in Brussels--preliminary results -- Obesity among young adolescent Kuwaitis -- Dynamic changes in adiposity from fetal to postnatal life are involved in the adult metabolic syndrome associated with reduced fetal growth -- Excess fetal adiposity is associated with programming of placental lipid genes -- Appetite control in breastfed and formula fed infants -- What are the Danone Institutes.

User-friendly and well organized, Easy EMG is designed to help residents learn the fundamental principles of electrodiagnostic testing (including nerve conduction studies and needle EMG). This one-of-a-kind resource offers expert guidance on performing and interpreting EMGs, as well as how to test the most common conditions encountered in daily practice. At-a-glance tables combine with clear illustrations and a pocket-sized format to make Easy EMG ideal for on-the-go reference!

Eating disorders, addictions, and substance use disorders are each challenging in their own right, but they also commonly co-occur, causing major challenges for clinicians. Emerging research suggests that there are common substrates at the neuroanatomical, neurochemical, and psychological levels. While randomized controlled trials have revealed a number of effective psychotherapeutic and psychopharmacologic treatments for the individual conditions, little is known about integrative interventions for these comorbidities. This book presents cutting-edge research on the overlap of these complex disorders and reviews integrative assessment strategies and treatment approaches, including enhanced cognitive behavioral therapy, dialectical behavior therapy, abstinence approaches, motivational enhancement, mindfulness meditation, and pharmacotherapy. The issue of whether eating-disordered behaviors such as dieting, binge eating, and excessive exercise are merely other forms of addictive behavior is examined. The authors argue both for and against the concept of food addiction in research, clinical treatment, and public policy.

At least 40 skin signs are associated with eating disorders (EDs), and some of them are considered guiding signs because they are indicative of an otherwise hidden ED. These skin signs may arise due to starvation, self-induced vomiting, drug consumption, and concomitant psychiatric illness. The role of the dermatologist in this context is to suspect the presence of a hidden ED based on the guiding signs. With this in mind, the most important specialists in the field come together in this book to document all of the dermatological aspects of EDs. General topics such as classification of EDs, epidemiology, and medical complications are first addressed, and skin signs attributable to various causes are then discussed in a series of detailed chapters. Characteristic changes in the hair, nails, and oral cavity are also carefully documented. The closing chapters address various other related issues of interest, including pain sensitivity in patients with EDs and the effects of anorexia nervosa on skin thickness and skin collagen. Eating Disorders and the Skin will be an invaluable source of up-to-date information for both novice and experienced dermatologists, as well as other practitioners with an interest in EDs, psychiatrists, and nurses.

"Foreword When I was a young woman being treated for an eating disorder, certain assumptions were made: if you had an eating disorder, you would be a white adolescent girl from a family with a controlling mother and an absent father. You would display a passive personality and low self-esteem. You would in all likelihood have signs of depression; whether you did or not, you would probably be treated for it. Your treatment team would see and treat you as childish and immature, and hold a variety of vague and often unfounded opinions about who you were, where you'd been, and what kind of chances of recovery you had. Those chances were considered, almost across the board, very low indeed. I was treated for eating disorders in the 1980s and 1990s. The medical and therapeutic understanding of the etiology, nature, and treatment of disordered eating and body image had not changed markedly since the early days of eating disorder research 20 years before. Likewise, the limited understanding of the demographics of eating disordered populations ensured that thousands would go undiagnosed and untreated. While the eating disordered population exploded, research and treatment providers held fast to their notions of what they were dealing with and how they should proceed. Their abysmal success rates bewildered them; they attributed these low rates of recovery to the intractable, probably incurable nature of the diseases. This second edition of Eating Disorders in Women and Children: Prevention, Stress Management, and Treatment is being released into a therapeutic community that has changed in many critical ways, and I believe the community will see further change as a result of the research done here"--Provided by publisher.

The Overview of Needs and Requirements covers the costs of the Ebola response and preparedness activities. The needs and requirements are based on the latest information available from each of the most affected countries. The national plans and budgets comprise the framework and the Overview of Needs and Requirements defines the contributions planed by the UN system as well as the major international civil society organizations.

The ECG in healthy people -- The ECG in patients with palpitations and syncope -- The ECG in patients with chest pain -- The ECG in patients with breathlessness -- The effect of other conditions on the ECG -- The ECG in pacemakers, defibrillators and electrophysiology/ David Adlam -- Conclusions : four steps to making the most of the ECG

This atlas of echocardiography presents more than 100 cases of adult congenital heart disease, from diagnosis to treatment follow-up. The coverage is broad, encompassing atrial and ventricular septal defects, patent ductus arteriosus, cyanotic adult congenital heart disease, and numerous other anomalies, as well as findings on fetal echocardiography. For each disease, all echocardiographic images and views which proved of diagnostic value are arranged sequentially, with inclusion of transesophageal echocardiographic images whenever appropriate. Additional pertinent information is provided relating to diagnosis and treatment, and key teaching points are highlighted. The superb quality of the illustrations and the range of cases considered (including many rare ones) ensure that this atlas will be of great value for cardiology residents and fellows and highly relevant to day-to-day practice.

Echocardiography has become an invaluable tool in intensive care medicine because of its ease of use and instantaneous provision of precise information on cardiovascular functional anatomy at the bedside. This book contains all the information that readers will require in order to perform echocardiography and lung ultrasound, and to interpret the findings correctly, permitting optimal guidance of the hemodynamic management of unstable patients. Furthermore, lung ultrasound is dealt with for both diagnosis and treatment of respiratory failure requiring mechanical ventilation. After an introductory chapter on the essential physics of ultrasonography, standard echocardiographic examination via both the transthoracic and the transesophageal approach is described. In the third section, the functional anatomy of all normal and pathologic thoracic structures as observed on echocardiography is presented in detail. A wide range of basic and advanced applications of echocardiography in the emergency and intensive care setting are then described. A final supplementary section considers further applications of ultrasound in the intensive care unit, such as ultrasound-guided vein cannulation, Doppler renal evaluation, transcranial Doppler, and lung and pleural ultrasound. This superbly illustrated book has been specifically designed to meet the needs of all intensivists, emergency physicians, and anesthesiologists who intend to use ultrasound extensively to guide optimal management of the critically ill.

This book provides a comprehensive account of the role of echocardiography in patients with mitral valve disease. The normal echocardiographic anatomy of the mitral valve is first presented, and the applications of echocardiography in mitral valve disease are then covered in detail by experts from different subspecialties in cardiology. Topics include etiology, pathophysiology, diagnosis, assessment of severity, and role of echocardiography in percutaneous and surgical techniques. The highly readable text is supported by a wealth of color images obtained with 3D echocardiography, currently the gold standard for the evaluation of mitral valve disease. The interdisciplinary approach used in describing the diagnostic and therapeutic applications will make this book useful for the clinical cardiologist as well as the echocardiographer. It will allow cardiologists to advance their knowledge in the field and will serve as an excellent updating tool for professionals engaged in echocardiography and cardiac diagnostic imaging.

Ultrasounds, a much reflected system -- The doctor in front of the machine -- The doctor and the machine in front of the patient -- The doctor, the machine, and the patient in front of the screen -- Learning methods -- Self-training procedure.

Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly flourished. This book presents a comprehensive overview of both pathophysiological and practical aspects of circulatory and respiratory extracorporeal support. The basics of ECMO, including its history, the "ECMO team", cannulation, materials, and blood-surface interactions, are first discussed. The various indications for and particular characteristics of circulatory and respiratory extracorporeal life support are then described in detail in the main part of the book. Patient care during ECMO and monitoring of the ECMO patient are also carefully covered, with explanation of the management of technical and clinical complications and transport-related problems. Further topics include long-term therapy options beyond ECMO, such as ventricular assist devices and transplants, outcome, the new frontiers of ECMO for organ procurement and future challenges. The authors are well-known experts in the field whose authoritative contributions and attention to practical aspects will be invaluable for novices and experienced practitioners alike.

Understanding the causes and consequences of biological diversity remains the unifying goal of ecology and evolutionary. One promising avenue to understand the causes and consequences of genetic diversity within populations is to consider correlations between that genetic diversity and species diversity of the community in which it resides. Both genetic and species diversity can respond to locality characteristics, or each level can influence and be influenced by the other. First, I investigate how area connectivity and gene flow affects the population genetic diversity patterns in the California vole (Microtus californicus). I show that migration across the landscape produces an identical genetic patterns at the local and regional spatial scales in this small mammal (Chapter 1). Next, I explored two ways in which genetic and species diversity influence each other. In one approach, I examine the effects of a species-rich competitor community on the genotypic diversity of a focal community when genetic diversity allows for differential strength of competition with different species. Using computer simulations, I show that species diversity of competitors can act as an important promoter of genotypic diversity within species (Chapter 2). Next, moving to a riparian community in northern Utah, I demonstrate that the genetic diversity of a foundation tree correlates positively with the species diversity of understory plants, including forbs, grasses, and vines (Chapter 3). Finally, I show that both genetic diversity and species richness across the globe show a similar pattern: genetic markers in over 70 vertebrate species show a significant trend of higher diversity at low latitudes than at higher latitudes (Chapter 4). By taking a broad approach to understanding the causes and consequences of intraspecific genetic diversity, with a particular focus on links to species diversity patterns, my dissertation finds general principles that operate across systems. The two levels of diversity can influence each other by creating spatially-varied selection regimes, but gene flow and mutation are two processes operating on the genetic level whose power to scale up to influence species-level patterns is highly contextual.

"Researchers in the field of ecological genomics aim to determine how a genome or a population of genomes interacts with its environment across ecological and evolutionary timescales. Ecological genomics is trans-disciplinary by nature. Ecologists have turned to genomics to be able to elucidate the mechanistic bases of the biodiversity their research tries to understand. Genomicists have turned to ecology in order to better explain the functional cellular and molecular variation they observed in their model organisms. Ecological genomics covers 3 fields of research that have most benefited from the recent technological and conceptual developments in the field of ecological genomics: the study of life-history evolution and its impact of genome architectures; the study of the genomic bases of phenotypic plasticity and the study of the genomic bases of adaptation and speciation"-- Publisher's description.

Recent work on the human microbiome represents the essence of community ecology: "What makes assemblages of species more or less similar to each other at different places and times?" (Vellend 2010; Anderson et al. 2011). The complex microbial communities of the human subgingival crevice are particularly relevant since multiple, spatially distinct but ecologically similar sites are found in a single subject. Healthy sites and sites affected by periodontitis (gum disease) can coexist in the same mouth simultaneously; periodontal disease may reflect community processes since it is thought to have a polymicrobial etiology rather than a single species etiology in the tradition of Koch's postulates. Subgingival communities therefore provide a unique, clinically relevant context to apply ecological concepts. The goal of this work was to advance our ecological understanding of the human subgingival microbiota, drawing on two fields of ecological research: biogeography and the stability of complex communities. The first half of this work explored oral biogeography and treating subgingival sites as isolated, island-like patches of similar habitat distributed within a mouth. A survey of twenty-three to thirty subgingival sites per mouth within five periodontally healthy subjects uncovered non-random, spatially relevant patterns of community distributions. Specifically, a left-right symmetric pattern of community similarity and a positive correlation between physical distance between sites and the dissimilarity of their respective communities were observed. However, these patterns were only discernable among deeply sequenced communities. Additional applications of co-occurrence analysis and neutral theory models to the data indicated that both competitive interactions and stochastic, demographic processes influence distributions of subgingival taxa. The second half of this work assessed the temporal stability of health and periodontitis-associated subgingival and salivary microbial communities before and after a single disturbance event of professional teeth cleaning. Communities were surveyed in 8 subjects (4 healthy, 4 with moderate chronic periodontitis), at 4 sites per subject, and at four sampling times ranging from 2 weeks to 1 day before the cleaning to assess baseline spatial and temporal variation. Samples collected at seven time points ranging from 1 hour to 3 months after the cleaning were also examined in order to monitor the compositional response to the perturbation. The results of this work demonstrated that healthy and periodontitis-associated subgingival communities are resilient to a teeth-cleaning perturbation, but the displacement of community composition immediately after cleaning was greater in periodontitis than in health. Periodontitis-associated subgingival communities more closely resembled a health-like composition as they recovered from the cleaning, although this change was transient. Salivary communities were also shown to be resilient to a teeth cleaning perturbation, but the impact of the cleaning on community composition is less pronounced in saliva. The results further suggest that post-cleaning residual subgingival communities contribute more to subgingival recolonization than salivary communities. The results of this work generated testable hypotheses about the ecological mechanisms governing observed spatial and temporal patterns. I hope these findings will contribute to the development of novel, ecologically informed approaches to the clinical treatment of the subgingival environment.

Human immunodeficiency virus (HIV) is a significant problem worldwide as well as in the United States (US), despite ongoing efforts to limit HIV transmission. In the US, men who have sex with men (MSM) account for over half of new HIV infections every year, and thus are an important group to consider for HIV interventions. Both prevention and treatment options are available to combat HIV transmission, but decision makers must prioritize among the available disease control strategies. Mathematical modeling frameworks can be used to assess the value and efficiency of various disease control measures and help inform resource allocation decisions. This dissertation describes research on economic analysis of HIV prevention and treatment portfolios, primarily for MSM in the US. We develop two independent mathematical modeling frameworks, both intended to assist decision makers with minimizing HIV transmission in the most cost-effective manner. First, in Chapter 2, we present a dynamic compartmental model of the HIV epidemic that we built and instantiated for MSM in the US. This model can be used to assess the effectiveness and cost-effectiveness of prevention and treatment programs for MSM. In particular, in Chapter 3 we examine testing for and treating acute HIV infection, and in Chapter 4 we examine preexposure prophylaxis for HIV prevention. We find that symptom-based testing for acute HIV infection is cost-effective for MSM in the US, but incorporating testing for acute infection into the standard HIV screening protocol is not. For preexposure prophylaxis, we find that it is not cost-effective for the general MSM population, but it provides good value in high-risk MSM. In Chapter 5, we present a resource allocation framework for determining the optimal mix of HIV treatment and prevention programs, given a fixed budget. We develop methods of linearly estimating health benefits and costs that account for epidemic effects of reducing disease transmission. We illustrate our model with the examples of preexposure prophylaxis and community-based education compared with antiretroviral therapy for MSM in the US. We show both analytically and with the examples that HIV budgets are often best spent on the program that offers the greatest "bang for the buck.".

Economic evaluation in health care: evidence-based medicine and evidence-based health economics -- Genomic medicine today: an introduction for health economists -- Economic evaluation and genomic medicine: what can they learn from each other? -- Introduction to the technical issues of economic evaluation -- Advanced methodological aspects in the economic evaluation -- Economic evaluation in the genomic era: some examples from the field -- Special requirements for economic evaluation and health technology assessment in genomic medicine -- A new methodological approach for cost-effectiveness analysis in genomic medicine -- Conclusions and future perspectives.

The book presents a basic introduction to epidemiology from the perspective of economics, using economic modeling to better understand and describe how infectious disease spreads. Three main elements are introduced: epidemiology, social network analysis, and the economics needed to model the behavior of individuals in the presence of infectious disease. The book aims to provide a starting point for discussion between medical professionals, social scientists and public health officials, the three groups interested in the spread of disease.

"In response to the growing concern about equity issues and their implications for overall development, WHO established the Commission on Social Determinants of Health (CSDH) in 2005, which focused on the "social justice" or human rights arguments for health investments. CSDH investigated the factors involved in the so-called "social gradient in health", which refers to the large observable differences in health outcomes within and between countries that are determined by avoidable inequalities in the access to resources and power. CSDH aimed to further investigate the causes of health inequities, with a deliberate detachment from economic considerations, and provide advice on how to tackle them effectively. CSDH also reviewed evidence for action on a wider scope of interventions than CMH, many of which require intersectoral collaboration or advocacy. With CMH and CSDH having adopted different but perhaps complementary standpoints, it soon became clear that greater synergies had to be forged between the two. This WHO resource book on the economics of social determinants of health and health inequalities seeks to begin to build a bridge between the two approaches by explaining, illustrating and discussing the economic arguments that could (and could not) be put forth to support the case for investing in the social determinants of health on average and in the reduction in socially determined health inequalities. The resource book has two main objectives: -- to provide an overview and introduction into how economists would approach the assessment of the economic motivation to invest in the social determinants of health and socially determined health inequities, including what the major challenges are in this assessment; -- to illustrate the extent to which an economic argument can be made in favour of investment in three major social determinants of health areas: education, social protection, and urban development and infrastructure."--WHO website

"The third edition of a bestseller, this book describes how chemical toxins and biological hazards impact the environment and people. Addressing how pollutants can alter the environment by contributing to global climate change, the author explores a broad range of environmental and health aspects of chemical and biological hazards. He includes numerous examples of the intimate relationship between ecosystem health and human health and emphasizes the need to consider this relationship whenever human activities are likely to have a significant environmental impact"-- Provided by publisher.

"ENOX Proteins" documents a unique family of cell surface proteins which are the exclusive discovery (subsequently confirmed by others) of the authors, their students and their colleagues. An ENOX-based mechanism is provided for how cells increase in size that is both unique and applicable not only to cancer and cancer therapy but also to production agriculture and biomass increase. The role of ENOX proteins in biological time-keeping is described along with evidence for oscillations in the ratios of electron spin pairs defining ortho and para water states that form highly coordinated populations of coherent water of interest to physicists as the underlying mechanism. The age-related NADH oxidases that appear around age 30 and increase steadily thereafter with potentially causal involvements in atherogenesis and skin aging have been identified as five members of the TM-9 protein superfamily of all with different chromosomal locations. The arNOX proteins initially are membrane anchored but functionally-active N-terminal fragments that are shed into body fluids. Except for critical functional motifs, all of the ENOX protein family members have distinct protein sequences and chromosomal origins. A fourth member of the ENOX protein family occurs in plants as the primary target for both natural and synthetic growth hormone (auxin)-stimulated rapid cell enlargement. Despite masquerading as intractable and difficult to clone and characterize, ENOX proteins offer remarkable opportunities for research, commercial development and outside confirmation of new paradigms to help explain complex biological processes.

Comprised exclusively of clinical cases covering ectopic pregnancy, this concise, practical casebook will provide clinicians in reproductive medicine and obstetrics/gynecology with the best real-world strategies to properly diagnose and treat the various forms of the condition they may encounter. Each chapter is a case that opens with a unique clinical presentation, followed by a description of the diagnosis, assessment and management techniques used to treat it, as well as the case outcome and clinical pearls and pitfalls. Cases included illustrate different management strategies ? from treatment with methotrexate to surgical interventions ? as well as types of ectopic pregnancy, such as ovarian, interstitial, heterotopic and abdominal forms, among others. Pragmatic and reader-friendly, Ectopic Pregnancy: A Clinical Casebook will be an excellent resource for reproductive medicine specialists, obstetricians and gynecologists, and family and emergency medicine physicians alike.

"A revised and expanded edition of the groundbreaking Edison in the Boardroom, highlighting the winning strategies today's biggest companies use to maximize the value of their intellectual property Now fully revised and expanded, Edison in the Boardroom, Second Edition takes an in-depth look at the revolutionary concept of intellectual asset management (IAM). Incorporating stories and teachings from some of the most successful companies in the world--such as Hewlett-Packard, IBM, Procter & Gamble, Rockwell, Dow, Ford and many others--Harrison and Sullivan have made an exhaustive study of IAM and its implications for today's businesses. Features updated interviews of companies, and a new treatment of the Profit Center LevelUp dates stories and teachings from some of the most successful companies in the world Showcases a hierarchy of best practices that today's companies can integrate into their own business philosophies to gain the best return from their intellectual assets Edison in the Boardroom, Second Edition compiles a wealth of knowledge and successful stories that illustrate how far businesses have come in their ability to leverage and monetize their intellectual assets"-- Provided by publisher.

Based on a study of physician education by the Carnegie Foundation for the Advancement of Teaching. Calls for a major overhaul of the present approach to preparing doctors for their careers. The text addresses issues for the future of the field and takes a comprehensive look at the most pressing concerns in physician education today.-- excerpted from publisher notes.

Contains a database of approximately 70,000 reactions and 4000 of the most frequently consulted reagents. Fully searchable by structure and sub-structure, reagent, reaction type, experimental conditions, and keyword. Also includes a searchable interface: Acronym finder (an interface for Scientific and technical acronyms, symbols, and abbreviations).

This book explains how training in arthroscopic skills is best carried out in order to keep up to date with advances in arthroscopy, meet the ever-increasing demand for high-quality care, and respond to changes in available training time. State of the art developments regarding tools, performance monitoring, and learning strategies are presented, and practical guidelines provided for direct implementation in daily clinical practice. The coverage of simulation-based training ranges from the use of wet labs and box trainers through to sophisticated virtual reality simulators. Subsequent sections on objective performance tracking of training outside and in the operating room cover a variety of key aspects, including psychomotor learning, the adequacy of performance measures, evidence-based thresholds, preclinical training strategies, the role of global rating scales, and video tools. As a result of the success of arthroscopy, its role in the orthopaedic armamentarium is continuously increasing and ever more complex surgeries are being performed arthroscopically. Effective training in arthroscopy is essential to good outcomes. The guidance provided in this book by acknowledged experts in the field will assist in improving the efficiency and effectiveness of arthroscopic training and in enhancing patient safety.

Rupture of the anterior cruciate ligament (ACL) is one of the most common injuries to the knee. Unfortunately, individuals who experience this injury are likely to develop osteoarthritis of the knee much earlier than would be expected due to the normal ageing process, and this remains true even after surgical reconstruction of the ligament. Research has suggested that a major contributing factor to the development of premature osteoarthritis is altered knee mechanics which change the loading conditions of the cartilage in the joint. Furthermore, it has been shown that altered knee mechanics are present following rupture of the ACL and persist after reconstruction surgery. Despite initial reports, there still remains a need for a comprehensive understanding of both altered knee mechanics in both ACL deficient and ACL reconstructed knees as well as changes in cartilage morphology following ACL injury. Therefore, the goal of this dissertation is to address the question of the relationship between certain changes in knee mechanics and cartilage morphology as they relate to the development of osteoarthritis following both ACL injury and reconstruction. The first study presented involves an analysis of the knee mechanics in individuals with unilateral ACL deficiencies. This group was important in that they were free of knee pain and had no sign of osteoarthritis on MRI over a time frame that ranged up to three decades from injury. This provided a unique opportunity to explore the potential for a protective functional adaption. The results of this study suggest that alteration in knee mechanics may act as a protective mechanism against osteoarthritis development since when subjects were separated into "Short Term" and "Long Term", based upon the time from injury, only those in the "Long Term" group demonstrated a relationship between the external knee flexion moment, which is representative of the interaction between quadriceps and hamstrings muscle to control rotation and translation during walking. This is indicative of an adaptive control mechanism present in some subjects who were able to last many years after the injury without reconstruction surgery. These results suggest the potential for new methods for rehabilitation following ACL injury. The second study presented involves an analysis of the knee mechanics of individuals with unilateral ACL reconstructions during gait, stair ascent, and stair descent at two years from surgery. The results demonstrate a reduction in the external joint moments of ACL reconstructed knees and an increase in the joint moments of uninjured contralateral knees during each activity compared to healthy controls. This suggests two things: 1.) compensation for residual muscle weakness in the affected limb is needed by the contralateral knee during ambulation and 2.) a decrease in daily joint loading in ACL reconstructed knees and an increase in joint loading in contralateral knees. Decreased loading of the ACL reconstructed knee may seem counterintuitive to what was expected in patients who will likely develop premature osteoarthritis in this knee. However, this finding is consistent with the suggestion that changes in joint kinematics and even decreased joint loading following the injury may contribute to the initial cartilage breakdown. Note: Taken together the results of study 1 and 2 suggest that the interaction between muscle function and kinematics should be further considered in the development of knee OA in this population. The third and final study involves articular cartilage morphology analysis of individuals with unilateral ACL reconstructions at two and four years from surgery. The results illustrate differences between cartilage thickness of ACL reconstructed and healthy contralateral knees at both times of testing. The findings show significantly thinner cartilage in the lateral tibial compartment of ACL reconstructed knees at two years from surgery. These differences became more pronounced at four years from surgery and include the addition of a significantly thicker medial region of the tibia of ACL reconstructed knees compared to healthy contralateral knees. The results indicate that patterns of cartilage thickness change are detectable as early two years following ACL reconstruction, and these patterns become more pronounced at 4 years which suggests cartilage begins a degenerative pathway substantially in advance of clinically detectable OA. This finding is important since it provides a basis for assessing early interventions to reduce the risk of knee OA following ACL injury. This dissertation helps to further the understanding of altered knee mechanics following both ACL rupture and reconstruction. In addition, a possible pattern of OA initiation has been reported. Each of these studies will benefit future studies with the ultimate goal of a complete understanding of OA initiation and development in ACL ruptured and reconstructed knees.

Drug use and abuse continues to thrive in contemporary society worldwide and the instance and damage caused by addiction increases along with availability. The Effects of Drug Abuse on the Human Nervous System presents objective, state-of-the-art information on the impact of drug abuse on the human nervous system, with each chapter offering a specific focus on nicotine, alcohol, marijuana, cocaine, methamphetamine, MDMA, sedative-hypnotics, and designer drugs. Other chapters provide a context for drug use, with overviews of use and consequences, epidemiology and risk factors, genetic.

The project reported here, sponsored by the American Medical Association (AMA), aimed to describe the effects that alternative health care payment models (i.e., models other than fee-for- service payment) have on physicians and physician practices in the United States. These payment models included capitation, episode-based and bundled payment, shared savings, pay for performance (PFP), and retainer-based practice. Accountable care organizations and medical homes, which are two recently expanding practice and organizational models that are based on one or more of these alternative payment models, were also included. Project findings are intended to help guide efforts by the AMA and other stakeholders to make improvements to current and future alternative payment programs and help physician practices succeed in these new payment models--i.e., to help practices simultaneously improve patient care, preserve or enhance physician professional satisfaction, satisfy multiple external stakeholders, and maintain economic viability as businesses

T cells will usually recognize any pathogen that threatens the body, despite the many different and constantly changing forms these pathogens can take. This is accomplished by the enormous diversity of T-cell receptors that are randomly generated during T-cell maturation. There are a number of distinct mechanisms that drive this diversity: one is the recombination of gene segments, (designated V, D, and J), from pools of many possible gene segments. Another is the addition and deletion of nucleotides at the gene segments joints (between the V, D, and J segments). This yields ~10^15 different possible T-cell receptors, which is many times greater that the number of T cells in the periphery of either mice (~10^8) or humans (~10^11). The T-cell receptor is formed from two polypeptide chains, α and β, each derived from separately rearranged gene segments. Each chain is composed of semi-randomly chosen gene segments. We utilized three transgenes, one limiting the α chain and two limiting the β chain. These progressively limited the number available gene segments of 100 Vα's to 1; 50 Jα's to 2; 30 Vβ's to 1; 2Dβ's to 1 and 13 Jβ's to 2. This reduced the number of gene segment combinations from a theoretical 3,900,000 to 4 combinations. The addition and deletion of nucleotides at the gene segment joints is unaffected. In an in vivo CTL killing assay, the mice with these limited T cell repertoires are able to recognize most but not all of the antigenic peptides tested (9 of 11, in the most restricted mice). Their immunity to Listeria monocytogenes was reduced somewhat; but the LD50 of Yersinia pseudotuberculosis was not diminished by limiting T-cell repertoire, and viral load after murine cytomegalovirus infection was similar to wild type. The limited repertoire mice also exhibited less vigorous alloreactive responses to some haplotypes, indicating that alloreactive responses are influenced by V gene segment compatibility with the MHC. We conclude that N and P nucleotide addition is sufficient for the bulk of T-cell immunity, at least in the laboratory setting. Limiting V(D)J gene segment choice, despite eliminating some T-cell specificities, does not have a dramatic effect on T-cell immunity.

The development of atherosclerosis, a chronic inflammatory disease of the arteries, can usually be attributed to specific regions of the blood vessel. In the straight segments of an artery, endothelial cells (ECs) align with the unidirectional blood flow which commonly occurs in these simple geometries. The elongated and aligned ECs are generally found to have a healthy, athero-resistant phenotype. In contrast, branches or curved vessel geometries have regions of disturbed flow, characterized by low shear stress and high shear stress gradients. In these regions of complicated flow patterns, ECs are non-aligned and have a cobblestone cellular morphology. The non-aligned ECs elicit biological properties that promote atherosclerosis, as the location of atherosclerotic fatty plaque is often found at these bends, branches, or bifurcations. Therefore, this correlation highly suggests that the morphology and biological function are inextricably linked in ECs. The ability to regulate both EC morphology and motility, with the aim to influence EC biology, might be highly beneficial in the prevention or treatment of vascular disease. In this dissertation, anisotropic matrices of collagen nanofibrils were fabricated with a simple flow processing technique and used to investigate fundamental cell-matrix interactions with ECs. The aligned fibrils were able to regulate both the morphology and biology of ECs, thereby suggesting the nanofibrillar collagen can be a useful tool to maintain vascular homeostasis. The ECs elongated and organized their actin cytoskeleton along the direction of the aligned collagen fibrils, as demonstrated by organized actin, microtubule networks, and focal adhesions. The nanofibrillar collagen also promoted increased cellular migration along the direction of the nanofibrils. The quantification of monocyte adhesion and expression level of adhesion molecules, known testing indicators of atherosclerosis development, suggested the aligned nanofibrils also promoted an athero-resistant phenotype in the ECs. ECs are subject to biophysical cues in vivo, either in the form of surface topography (provided by the basement membrane of the ECM) or the hemodynamic effects of blood flow. The combination of these cues regulate the organization and immunogenicity of ECs and is representative of the in vivo environment. Therefore, we also investigated the endothelial behavior when both types of cues (topography and flow) were simultaneously present. At physiological levels of high shear stress (14-17 dynes/cm2), the matrix-aligned ECs were able to resist reorientation despite shear flow perpendicular to the matrix direction. The anisotropic collagen matrix could preserve the alignment and elongation of ECs as well as promote an athero-resistant phenotype after exposure to antagonistic perpendicular flow. The ability of the anisotropic nanofibrillar collagen to regulate cell morphology and especially EC immunogenicity highlights its potential in the treatment of vascular diseases. Therefore, an aligned conduit of collagen nanofibrils was fabricated to address the need for a small-diameter vascular graft capable of regulating cellular function. The vascular graft was designed to have a mechanical integrity comparable to that of native vessels and was able to regulate EC attachment, morphology, and phenotype. In addition, the aligned collagen grafts could support an anti-thrombogenic surface modification, providing short-term patency in the carotid artery model of Sprague-Dawley rats.

The meeting of Aquatic Noise 2013 will introduce participants to the most recent research data, regulatory issues and thinking about effects of man-made noise and will foster critical cross-disciplinary discussion between the participants. Emphasis will be on the cross-fertilization of ideas and findings across species and noise sources. As with its predecessor, The Effects of Noise on Aquatic Life: 3rd International Conference will encourage discussion of the impact of underwater sound, its regulation and mitigation of its effects. With over 100 contributions from leading researchers, a wide range of sources of underwater sound will be considered.

In the last 100,000 years, humans have been subjected to multiple different evolutionary pressures. Migration events, changing food sources, climate change, and technological advances are some of the ways environmental changes have applied pressure on human populations to undergo change. Recent advances in methods to measure differences in DNA sequences have led to new powerful techniques to measure the effect of evolution on different human populations. Also due to the availability of recent explosion of genomic data, our understanding of genetic basis of human disease has grown significantly. However, our knowledge regarding the effect that recent evolution has had on the genetic susceptibility to disease has grown to a much lesser extent. There is a lack of studies attempting to place the genetic basis of disease in the context of recent evolutionary changes. I describe multiple ways in which recent evolutionary pressures on the human genome can lead to insights to understanding how evolution has impacted complex disease. I show that GWAS (Genome-Wide Association Studies) are particularly well suited to measure the effect of recent evolution in complex disease. I provide methodology to detect positive selection in human disease and are able to ascertain whether recent evolution has disproportionately increased or decreased the risk of inherited disease. In addition, I introduce a method to approximate when and where genetic risk differentiation for specific disease has occurred, starting when humans began migration out of Africa. Environmental changes in the last 10,000 years known to have created novel, diverse, and pervasive pathogens. I provide methodology to find positive selection in communicable disease. I identify populations that have most likely been severely impacted by specific pathogens in recent human history. I develop and apply methods to identify specific genetic variants important to both communicable and inherited disease that have been affected by evolutionary pressures. I find that type 1 diabetes has recently undergone strong positive selection towards increasing genetic risk in European derived populations. In addition type 2 diabetes and pancreatic cancer is associated with migration trajectories and I find genetic risk differentiation exceeding what is expected by genetic drift in a total of 11 complex diseases. Finally, I find evidence of positive selection in many distinct populations within proteins interacting bacillus anthracis and yersinia pestis, which cause anthrax and the bubonic plague, respectively. I have shown how recent evolution can lead to an increased understanding of both inherited and infectious disease.

The bryostatins are a family of structurally complex natural products isolated from the marine bryozoan Bugula neritina. Bryostatin 1 is currently being investigated for cancer, Alzheimer's and HIV/AIDS indications. Despite these remarkable activities, research on the bryostatins is hampered by their low natural abundance. Efficient access by total chemical synthesis has been in large part precluded by the bryostatins' structural complexity. This dissertation describes the design, synthesis, and preliminary biological evaluation of functional bryostatin analogs that possess biological activities comparable or superior to the natural product. These fully synthetic analogs were convergently assembled in a uniquely step-economical manner using novel macrocyclization strategies, including macroacetalization and Prins-driven macrocyclization approaches. Bryostatin analogs were identified that possess unique affinities (subnanomolar) and selectivities for protein kinase C (PKC). Synthetic bryostatin analogs also exhibit subnanomolar antileukemic activity in in vitro assays. The convergent total synthesis of bryostatin 9, a highly potent congener of the natural product family, is also described.

The heart is an essential heterogeneous organ that depends on strong coupling between electrical, chemical, and mechanical dynamics to properly function as a pump that supplies blood to the rest of the body. Cardiac arrhythmias are common disorders characterized by irregular beating of the heart that lead to serious clinical conditions. It is estimated that approximately 2.2 million adults in the United States are affected by atrial fibrillation, a prevalent arrhythmia. Unfortunately, a clinician often does not have enough information to diagnose a patient's heart condition to determine the optimal treatment procedure. This is an area that computational mechanics can address. While development of mechanical and electrophysiological models of cardiac tissue primarily started in the 1950s, fully-coupled models have only more recently been developed due to factors regarding computational cost, difficulty in quantifying material properties, and difficulty in integrating complex models in a cohesive and efficient manner. Therefore, in order for simulation tools to have impact in the clinical or experimental setting, these tools must be efficient, fast, robust, and accessible. The focus of this thesis is to develop methods of addressing the aforementioned issues and then illustrate how efficient electromechanical finite element models can be developed for the heart such that their use in the clinical and experimental setting can be realized in several examples. In this thesis, a global-local variable splitting formulation borrowed from the field of plasticity is used to address the issues of complex model integration, and to maintain numerical stability at low costs. Through careful examination of classical phenomenological models and detailed biophysical ionic models of the electrophysiology of the heart, almost all models can be reformulated into this global-local splitting framework. The numerical properties of cost-expensive ionic models are briefly analyzed within the context of this framework. Use of implicit-time stepping in tandem with a simple iteration and error tolerance based adaptive time-stepping algorithm allows for reduction of computation time from hours to minutes. Flexibility and modularity of the framework are illustrated through the development of electrical, electro-chemical, electro-chemical-mechanical, and opto-electro-mechanical models of cardiac tissue. The heart is modeled efficiently using custom finite element ventricular cell models for physiological electrical simulations and large deformation excitation-contraction dry-pumping simulations of the heart. The results accurately model the physiological condition of the heart. The flexibility and multiscale nature of the framework is also leveraged in developing novel optical-induced cardiac cell excitation models of new genetically engineered Channelrhodpsin-2 (ChR2) cardiac myocytes. An ionic model was developed for these particular bio-engineered stem cells, calibrated with experimental data from collaborators, and was able to predict the electrical excitation behavior of the cells to a reasonable degree of accuracy. This model was then combined with ionic pacemaker cell models and also with ventricular cell models into respective finite elements to simulate experiments and predict future therapies using ChR2 genetically modified cardiac tissue. The thesis also addresses difficulties relating to identification and characterization of material parameter identification in inhomogeneous cardiac tissue. Metrics for determining smoothness in electrical conduction in tissue cultures were validated with stochastic finite element models of microelectrode array cell conduction experiments. The results indicate that these metrics are useful in characterizing different conduction patterns based on two metrics borrowed from texture analysis. Difficulties in obtaining structural fiber data from clinical images were addressed by developing an algorithmic method for designating approximate physiologically accurate fiber distributions for the heart using only geometrical information obtained from MRI scans of the surfaces of the heart. Poisson interpolation is used and results in a smooth continuous rotating fiber description that matches experimentally obtained fiber directions from MRI scans. The main benefits of this algorithm are its simplicity of implementation, physiologically accuracy, and generality in interpolating fiber distributions. Lastly, the thesis demonstrates possible benefits of GPU computing in order to achieve near-real-time electrical simulations of arrhythmias in the heart. The assembly and solver routines from the finite element code, FEAP from Berkeley, were ported to the GPU using CUDA. Even with a minimally optimized proof-of-concept, the GPU-only finite element code achieves performance comparable to twelve cores using only one GPU. To increase the overall efficiency of the method, current sparse matrix vector multiplication GPU algorithms are analyzed, and possible alternative algorithms are developed specifically with unstructured finite element meshes in mind. Altogether, the different methods developed in this thesis have been shown to be effective in addressing issues related to efficiency, numerical stability, modularity, and flexibility in real computational applications of the heart. Special consideration was taken in designing the different methods to be compatible with one another, such that a majority of the methods could be integrated and the benefits of each method could be leveraged with each other to gain maximum efficiency. While these developed methods can still be improved, the thesis work as a whole serves to demonstrate and highlight future uses for computational models within experimental and clinical settings.

The central theme of this work revolves around the genetics of admixed individuals---individuals who derive their ancestry from two or more different ancestral populations.The genomes of admixed individuals exhibit unique properties that make them both fascinating and challenging to study using existing statistical methods. Their uniqueness lies in their block-like structure, a feature that is the direct result of generations of recombination events. An important advance in the field of admixture genetics has been the development of algorithms capable of determining the ancestry of different regions in the admixed genome. As we will illustrate in this work, local ancestry information can readily be harnessed towards the investigation of subcontinental structure, by which we attempt to determine the specific ancestral populations that gave rise to the admixed genomes under study, and whether differences exist in the ancestral makeup of these admixed samples. The latter line of investigation is of particular relevance to genome-wide association studies, which are prone to confounding if structure in a population has not been explicitly corrected for. This work is thus divided into three parts. We first apply some straightforward multivariate statistical methods such as PCA to gain insights into the African ancestry of African Americans. To this end, we introduce a novel method for the study of specific components of admixture in admixed individuals. We then expand on this work to introduce more sophisticated algorithms for the study of admixed genomics. These methods entail the development of an improved method for local ancestry deconvolution, and the implementation of a PCA approach designed to handle large amounts of missing data. We illustrate the power of using these methods in conjunction with one another with the study of two Latino populations. Finally, we describe a novel phasing algorithm designed to incorporate sequencing information into the process of haplotype reconstruction---an important upstream step for many of the analyses described here.

We present models and algorithms that can be applied to common problems in analysis of genomic data. These include CNV (Copy Number Variation) detection, local ancestry inference in admixed populations, and haplotype inference in panels of unrelated individuals. Chapter 2 proposes a new algorithm for the Fused Lasso Signal Approximator which was recently been proposed as an alternative to HMM's for CNV detection. Chapter 3 describes new models for local ancestry inference when high density genotype data is available, and our focus is on a higher order Autoregressive Hidden Markov Model (ARHMM). We give solutions to problems that have thus far prevented the use of higher order ARHMM's for this task, and we demonstrate the model on real and simulated data. Finally, in chapter 4 we given an approach for inferring haplotypes from unphased genotype data. We optimize a likelihood closely related to the PHASE model (which is considered one of the most accurate), and we show that the proposed approach is substantially more accurate than recent alternatives. The work in these chapters contributes to common and important tasks in analysis of genomic data for association studies.

The debate over eHealth is alive as never before. Supporters suggest that it will result in dramatic innovations in healthcare, including a giant leap towards patient-centered care, new opportunities to improve effectiveness, and enhanced wellness and quality of life. In addition, the growing market value of investments in health IT suggests that eHealth can offer at least a partial cure for the current economic stagnation. Detractors counter these arguments by claiming that eHealth has already failed: the UK Department of Health has shut down the NHS National Program for IT, Google has discontinued its Health flagship, and doubts have arisen over privacy safeguards for both patients and medical professionals. This book briefly explains why caregivers, professionals, technicians, patients, politicians, and others should all consider themselves stakeholders in eHealth. It offers myth-busting responses to some ill-considered arguments from both sides of the trench, in the process allowing a fresh look at eHealth. In addition, it describes how the technical failures of previous eHealth systems can be avoided, examines the legal basis of eHealth, and discusses associated ethical issues.

An overview of healthcare disparities -- Provider factors in healthcare disparities -- Patient factors in healthcare disparities -- Healthcare system factors in healthcare disparities -- The social "nonmedical" determinants of health -- The role of the Internet in American life -- The iHealth revolution -- Digital disparities -- The role of eHealth in patient engagement and quality improvement -- Medical informatics -- Public health informatics -- Beyond traditional paradigms in disparities research -- Health information technology policy perspectives and healthcare disparities -- Disparities and eHealth: achieving the promise and the potential.

Eiger is the sole TNF family member found in Drosophila melanogaster. This signaling molecule is induced during infection and is required for an appropriate immune response to many microbes; however, little is known concerning where eiger is produced and what genes are regulated by eiger. Here we show that eiger is made in the fly's fat body during a Salmonella typhimurium infection. Using tissue specific knockdowns we found that eiger expression in the fat body is required for all of the phenotypes we observed in eiger null mutant flies. This includes reduced melanization, altered antimicrobial peptide expression and reduced feeding rates. The effect of eiger on feeding rates alone may account for the entire phenotype seen in eiger mutants infected with S. typhimurium. We further characterized the eiger response using transcriptional arrays. We found that the eiger regulates a number of genes involved in metabolism and hormonal signaling during an immune response. How these genes are involved in the immune response is not clear. Finally we examined the role of age related decline of the immune system in D. melanogaster during bacterial infection. We found that vigor and tolerance are reduced when old flies are challenged with a variety of bacterial pathogens.

The past two decades have witnessed an explosion of knowledge and radical changes in our understanding of the molecular, ionic, genetic, and pharmacologic basis of electrical diseases of the heart. Electrical diseases of the heart are heritable arrhythmogenic clinical entities that may share common clinical and genetic features, yet may be distinctly different in their genesis, prognosis, and management. Notably, both congenital and acquired electrical diseases of the heart are receiving increased recognition as a result of important advances in genetic analysis. In this second edition of Electrical Diseases of the Heart, the Editors' goal has been to embrace and highlight the explosion of knowledge that our field has witnessed since the publication of the first edition. The approach continues to be one of bridging basic and clinical science in an attempt to advance meaningfully our understanding of heart disease and identify the knowledge gaps that exist. This volume covers the basic foundations and primary electrical diseases and with the companion volume provides the latest developments in the field of experimental and clinical cardiac electrophysiology, genetics, pharmacology and interventional therapies of various clinical arrhythmogenic entities. Residents, fellows and physicians in cardiology and electrophysiology will gain valuable insight into the latest developments in the field of cardiac electrophysiology and clinical electrocardiology by reading this book, including expert review of the genetic and epidemiologic considerations, diagnostic and therapeutic modalities of the newly discovered clinical syndromes and electrocardiographic phenomena, and their correlation with the most recent advances in the basic science.

"This book will enable the reader to gain a sound understanding of contemporary and futuristic evidence-based interventions and assessment procedures for pelvic floor disorders. It gathers the experiences of some of the most important experts on electrical stimulation techniques, offering a multidisciplinary and problem-oriented approach organized according to therapeutic goals. Interventions are recommended that are consistent with theory and display clinical efficacy for specific disorders, including urinary incontinence or retention, fecal incontinence, constipation, pelvic pain, sexual dysfunction, and neurological diseases involving the pelvic floor. All of the surgical or rehabilitative techniques requiring electrical stimulation for the treatment of these disorders are explored, and essential background information is provided on functional anatomy, neurophysiology, and concepts in electrotherapy. This volume will be a very useful tool for urologists, general or colorectal surgeons, gynecologists, and anesthesiologists, and also physiotherapists and alternative medicine practitioners (a specific chapter focuses on electroacupuncture). It will assist in their clinical practice as they seek to help the very many patients who suffer from any of the wide range of functional pelvic floor disorders"--Publisher's description.

Electrocardiography of Laboratory Animals is the only book covering electrocardiography of laboratory animals, including dogs, mini-pigs, and cynomologus monkeys. As more countries institute requirements for the care of laboratory animals in research, this publication offers an effective standard on performing and analyzing ECGs. Topics covered include safety electrocardiography, toxicology, safety pharmacology, and telemetry. Electrocardiography of Laboratory Animals will assist biological and medical researchers, veterinarians, zoologists, and students in understanding electrocardiography of various species of animals used in research. Covers safety electrocardiography of large laboratory animals. Offers comprehensive analysis of ECGs for practical laboratory use. Includes a self-evaluation section for testing of ECG reading and analysis.

The Human Genome Project was accomplished by a reduction in the cost of DNA sequencing by three orders of magnitude. Further cost reductions are required for sequencing to become a standard tool in clinical medicine and to enable personalized medicine via individual genome sequencing. The current cost varies between $50k to $100k over a period of months; depend on the technology, accuracy and read-length. It is desired to reduce the cost to $1000 per genome to enable profiling of individuals genome. To achieve this goal, a highly integrated platform with simplified chemistry is required. In this dissertation, we introduce a novel method for DNA sequencing based on electrical detection of polymerization reaction, called "Thermo/pH sequencing". Our proposed method is based on the direct measurement of the heat release or the pH modulation (change of H+ ion concentration in the solution) during DNA extension. For high throughput DNA sequencing, DNA strands are immobilized to small micron-size beads in a microfluidic platform. The DNA-beads are in a reaction mixture in contact with an array of sensitive micro-machined heat or pH sensors, which detect the electrical signature from incorporation of a complementary base (dNTP) in the presence of appropriate reagents (DNA polymerase, and polymerase reaction buffer). This results to a label-free, long-read and fast chemistry; 10x reduction in reagent cost with 10x increase in throughput can potentially yield to significant improvement in the cost of genome sequencing to less than $1000. In addition, substituting optical detection set-up with microelectronic sensor reduces the capital cost of sequencing instruments from $500k to less than $50k. We demonstrate the proof of concept for this technology at large scale. Then we describe the development of an appropriate microfluidic platform and two micromachined electrical biosensors that employ electrical detection for heat or pH detection. Both versatile platforms can be multiplexed and have the potential of providing rapid and inexpensive measurements without any compromise in the sensitivity, making them good potential candidates for use in the clinical setting. We report a chip-based integrated differential microfluidic nanocalimeters with on-chip injection and multiplexing unit, capable of characterizing the heat of reaction with unprecedented 2-nW resolution in 1 Hz bandwidth for nanoliter scale samples. We successfully demonstrate DNA Thermosequencing with sequential injection of different nucleotides into the integrated microfluidic calorimeter device. In addition, the device can serve as a powerful tool to characterize a variety of the biomedical processes, such as metabolic activities of microorganisms, living cells and catalyzed reactions. We also present a microfabricated device in microfluidics for pH sequencing, called nanoneedle biosensor. The key element for this device is a 10nm wide gap on the end of the needle of total diameter about 100nm. Any change in the population of molecules in this gap results in a change of impedance across the gap; single molecule detection should be possible. In addition, DNA-beads can be allocated iv near the sensors to measure the pH change during DNA extension. The design, fabrication, testing, optimization and a modified structure of the device for higher signal to noise ratio are presented. Toward an integrated sequencer platform, automation and reduced labor cost, higher throughput, accuracy and efficiency for genomics and proteomics analysis; further integration and optimization of the presented systems are required. We envision the integration of our CMOS-compatible devices with a CMOS integrated circuitry into a high throughput gene sequencer or proteomics system. The proteomics system enables multiplex analysis using an array of micro-channels for probing clinically relevant samples such as the human serum for various protein and nucleic acid biomarkers for cancer detection, and also the detection of pathogenic bacteria in solution.

"Discover How Electronic Health Records Are Built to Drive the Next Generation of Healthcare Delivery. The increased role of IT in the healthcare sector has led to the coining of a new phrase 'health informatics, ' which deals with the use of IT for better healthcare services. Health informatics applications often involve maintaining the health records of individuals, in digital form, which is referred to as an Electronic Health Record (EHR). Building and implementing an EHR infrastructure requires an understanding of healthcare standards, coding systems, and frameworks. This book provides an overview of different health informatics resources and artifacts that underlie the design and development of interoperable healthcare systems and applications. Electronic Health Record: Standards, Coding Systems, Frameworks, and Infrastructures compiles, for the first time, study and analysis results that EHR professionals previously had to gather from multiple sources. It benefits readers by giving them an understanding of what roles a particular healthcare standard, code, or framework plays in EHR design and overall IT-enabled healthcare services along with the issues involved. This book on Electronic Health Record: Offers the most comprehensive coverage of available EHR Standards including ISO, European Union Standards, and national initiatives by Sweden, the Netherlands, Canada, Australia, and many others; Provides assessment of existing standards; Includes a glossary of frequently used terms in the area of EHR; Contains numerous diagrams and illustrations to facilitate comprehension; Discusses security and reliability of data."--Publisher's description.

"The new edition of Electrophysiological Disorders of the Heart helps you diagnose and treat a full range of heart rhythm disorders using today's latest technologies and therapies. It provides practical, hands-on coverage of hot topics such as pediatric EP, imaging, echocardiography-guided EP procedures, regenerative therapies, cardiac pacing, and more. Now available in a new full-color format, the title also includes easy online access at www.expertconsult.com. "--Publisher's website.

Psychophysiology is an ever expanding field. The application of psychophysiological investigations to psychiatric disorders is likewise expanding and has in fact shed much light on some of the neural processes contributing to the development of psychiatric symptoms and/or their amelioration following treatment. The first part of this volume deals with a number of conditions where psychophysiological investigations have recently provided some insight into the pathophysiology of a particular manifestation (e.g., dissociation) or a disorder. Although this volume has a main focus on electrophysiological investigative modalities where neuroimaging was complimentary this added insight was included. The second part of the volume focuses on novel uses of psychophysiological measures, combining it with neuropsychology and imaging where possible, in the context of neuropsychiatric research and describes advanced analytical tools. Both basic and clinical investigators in this field should find the reviews and interpretations provided clear and informative. Clinicians will find this volume easy to assimilate. While direct clinical applications may be down the road, the insights provided should help the practicing clinicians to have firmer understanding of the complexity of the disorder they manage in everyday practice.

"Electrospinning is from the academic as well as technical perspective presently the most versatile technique for the preparation of continuous nanofibers obtained from numerous materials including polymers, metals, and ceramics. Shapes and properties of fibers can be tailored according to the demand of numerous applications including filtration, membranes, textiles, catalysis, reinforcement, or biomedicals. This book summarizes the state-of-the art in electrospinning with detailed coverage of the various techniques, material systems and their resulting fi ber structures and properties, theoretical aspects and applications. Throughout the book, the current status of knowledge is introduced with a critical view on accomplishments and novel perspectives. An experimental section gives hands-on guidance to beginners and experts alike."-- Provided by publisher.

This concise, high-yield title in the popular Integrated Review Series focuses on the core knowledge in immunology and microbiology while linking that information to related concepts from other basic science disciplines. Case-based questions at the end of each chapter enable you to gauge your mastery of the material, and a color-coded format allows you to quickly find the specific guidance you need. This concise and user-friendly reference provides crucial guidance for the early years of medical training and USMLE preparation. Effectively review for problem-based courses with the help of text boxes that help you clearly see the clinical relevance of the material.

Ewing's sarcoma is the second most common malignant bone cancer in children. The prominent defining feature of Ewing's sarcoma is a translocation event between a member of the FET family of RNA binding proteins and a member of the Ets transcription factor family. The majority of patients have a translocation event between the EWSR1 gene and the FLI1 gene. The EWS-FLI1 translocation was first discovered in 1992 and to date, the mechanism by which EWS-FLI1 induces the formation of Ewing's sarcomas remains unclear. Understanding the role of EWS-FLI1 in oncogenesis is critical for Ewing's sarcoma and would have broad implications for other cancers as well. Translocations involving members of the FET or Ets families are also found in leukemia, prostate cancer and other sarcomas. A primary goal of my graduate work has been to develop tools to express EWS-FLI1 in primary human cells as well as in genetically engineered mice to understand how EWS-FLI1 induces oncogenesis and determine the cell of origin in Ewing's sarcoma. As recent work suggested that Ewing's sarcomas arise from a mesenchymal stem/progenitor cell (MSC), we examined the effects of EWS-FLI1 expression in primary human MSCs. We isolated MSCs from pediatric patients at Lucile Packard Children's Hospital to establish human bone marrow derived MSC lines (which we call HBMs). Through a series of experiments, we learned that the precise expression levels of EWS-FLI1 were critical in determining the effect of this oncogene on primary cells. High expression of EWS-FLI1 was not tolerated in HBMs. In contrast, when expressed at lower levels, stable EWS-FLI1 expression was maintained in HBMs. To elucidate transcriptional targets of EWS-FLI1 in HBMs, we used next-generation sequencing (RNAseq) to identify genes dysregulated by EWS-FLI1. Using this approach we identified 170 targets that constitute an EWS-FLI1 expression signature, including novel target genes. Expression of a subset of these genes was dependent on EWS-FLI1 expression in Ewing's sarcoma cell lines, validating their regulation by EWS-FLI1. The majority of these target genes were required for growth in soft agar of Ewing's sarcoma cell lines and some also showed an effect on cell growth. Among these EWS-FLI1 target genes we focused on a novel long non-coding RNA, lnc277, which is induced and regulated by EWS-FLI1 in Ewing's sarcoma cell lines and in other human cell lines ectopically expressing EWS-FLI1. Expression of lnc277 is highly specific to Ewing's sarcoma and is required for cell growth and transformation by EWS-FLI1. To decipher a mechanism for how lnc277 functions in Ewing's sarcoma cells, we have used protein arrays to identify interacting proteins. Lnc277 appears to interact with several proteins involved in transcription, splicing, RNA stability and translation, including STAU1, HNRPK1 and several others. Additionally, we performed RNAseq analysis of lnc277 knock-down to identify specific genes whose expression is altered upon depletion of lnc277. To elucidate the cell of origin for Ewing's sarcoma and create a model that can be used to test novel strategies for treatment, we have genetically engineered mice to conditionally express the EWS-FLI1 translocation from the endogenous EWSR1 locus. We have generated mice that contain lox sites within both the EWSR1 locus and the FLI1 locus such that upon Cre recombinase expression, some cells will undergo a reciprocal recombination event, generating both the EWS-FLI1 and FLI1-EWS chromosomes. We have genomic DNA and mRNA confirmation that this recombination occurs in vitro and in vivo after expression of Cre recombinase. This is the first example to our knowledge of a mouse model that faithfully recapitulates a translocation mechanism in a solid tumor. The reciprocal translocation model relies on two chromosomes recombining with each other, an event that we have found to be highly rare with these two chromosomes in the mouse. Therefore, we focused our efforts on a second mouse model where the recombination event occurs much more efficiently, our EWS-FLI1-V5 mouse model. The EWS-FLI1-V5 mouse model expresses a V5-epitope tagged version of EWS-FLI1 also from the EWSR1 locus. To create this model, a FLI1 cDNA was introduced downstream of the EWSR1 gene on the same chromosome. The expression of Cre recombinase results in the formation of the translocation by splicing the N-terminal EWSR1 exons to a FLI1 cDNA containing the C-terminal exons. This model leads to expression of EWS-FLI1-V5 in the majority of cells where Cre is expressed. We have carried out in vitro studies expressing EWS-FLI1-V5 in mouse embryo fibroblasts (MEFs) and mouse MSCs. Whereas EWS-FLI1-V5 expression inhibits proliferation in MEFs, MSCs expressing EWS-FLI1-V5 continue to proliferate. We have demonstrated that several of the new target genes identified in the human system were also regulated by EWS-FLI1-V5 in mouse cells. We have crossed both our Ewing's sarcoma mouse models to four Cre strains that express Cre recombinase in mesenchymal tissues as well as one that expresses Cre recombinase in the neural crest lineage. Mice from the reciprocal translocation model failed to develop tumors, most likely because the translocation event was so rare either no cell recombined the EWSR1 and FLI1 loci or that EWS-FLI1 expression was not tolerated in the cells that did recombine the loci. The EWS-FLI1-V5 mice expressing EWS-FLI1 in the mesenchymal lineage using Dermo1-Cre, Col1[alpha]2-Cre, Prx1-Cre or Sox9-Cre died embryonically. Interestingly, we only obtained mice that could potentially be expressing EWS-FLI1-V5 in the neural crest lineage using P0-Cre, suggesting the expression of EWS-FLI1-V5 in these cells was not toxic or that other cells can compensate for loss of the cells expressing EWS-FLI1-V5. Whether these adult mice actually express EWS-FLI1-V5 in the tissues derived from the neural crest lineage and whether these mice are tumor prone are areas for future study. Through this thesis work, we have used a combined approach that leverages both human and mouse model systems to create an in vivo model of Ewing's sarcomagenesis. These models could be used to define the cell of origin for Ewing's sarcoma and gain an understanding of the genetic requirements for oncogenesis downstream of EWS-FLI1. Through our studies of pediatric human mesenchymal stem cells expressing EWS-FLI1 in Chapters 2 and 3, we have discovered a number of novel EWS-FLI1 target genes and identified a lncRNA that is highly specific to and required for EWS-FLI1 mediated oncogenesis. In Chapters 4 and 5, two novel transgenic mouse strains were generated to express the EWS-FLI1 gene fusion from the endogenous EWSR1 locus in a way that is physiologically relevant to Ewing's sarcoma. These tools should help define the effects of EWS-FLI1 expression in primary and cancer cells and hopefully result in new therapies to benefit children diagnosed with this disease.

The genome is under constant threat by DNA damage arising from endogenous and exogenous sources, and it is particularly susceptible to damage during DNA replication. Using a genome-wide siRNA screen to identify proteins necessary for genome maintenance in the presence of replication stress, we identified NEK8/NPHP9, a ciliary protein kinase associated with two renal ciliopathies in humans and mice, nephronophthisis (NPHP) and polycystic kidney disease (PKD). Renal ciliopathies are a leading cause of kidney failure, but their exact etiology is poorly understood. Recent findings have shown that several genes linked to the DNA damage signaling are mutated in patients with NPHP or NPHP-like diseases. However, whether loss of the DNA damage response (DDR) itself played a causal role in NPHP is not clear, and the underlying mechanism linking these genes to NPHP is not addressed. This thesis work provides new mechanistic insight into the functions of the NIMA-related kinase, NEK8, in suppressing DNA damage arising from replication stress, and for the first time connects the replication stress response to cystic kidney diseases and renal ciliopathies. Here we directly demonstrate that replication stress, caused by the DNA polymerase inhibitor aphidicolin, as well as NEK8 loss, affects renal cell architecture in a 3D-culture system. Moreover, NEK8 mutation leads to replication stress and DNA damage in the pre-cystic kidney. We further establish that NEK8 is a crucial effector of the replication stress response and that it functions as part of the ATR-dependent signaling pathway, regulating replication fork dynamics and fork stability through effects on CDK activity. We also show NEK8's role in the replication stress response is compromised by ciliopathy-causing mutations. Thus, our study strongly suggests that excessive replication stress or a defect in the ability of cells to respond to replication stress leads to chronic damage in renal epithelial cells and kidney failure in ciliopathies. The major contributions of this dissertation are: (1) We validated NEK8 as a high confidence hit from a previously described unbiased siRNA screen designed to uncover genes that help maintain genome stability during DNA replication stress. (2) Cells lacking NEK8 form spontaneous DNA double-strand breaks (DSBs) which further accumulate when replication forks stall. (3) NEK8 acts at the replication fork to regulate fork dynamics and replication origin firing, particularly under conditions of replication stress. (4) NEK8 functions in the ATR pathway, interacting with ATR and other components of the replication checkpoint, and it suppresses S-phase CDK activity during replication to prevent premature origin firing. (5) NEK8 mutations, which produce kinase-inactive protein or juvenile cystic kidneys (jck), abolish the interaction of NEK8 with ATR and fail to prevent DNA damage accumulation in NEK8-deficient cells. (6) Disruption of NEK8, as well as replication stress induced by aphidicolin, perturbs both ciliogenesis and spheroid structure in a 3D assay that models renal kidney architecture and NPHP. This study therefore provides the first direct evidence that replication stress contributes to renal ciliopathies and mechanistic insight into how it does so. Furthermore, it identifies a new critical component of the replication stress response: NEK8.

The ubiquitous parasite Toxoplasma gondii has developed an exquisite arsenal of effectors to support its intracellular lifestyle and its persistence within its diverse hosts. In order to survive and resist clearance, this obligate intracellular parasite must contend with the host immune response. Different strains of the parasite vary dramatically in their interaction with the immune system, and studying these strain differences has furthered our understanding of the spectrum of host-pathogen interactions and led to the identification of parasite effectors. The work described here dissects the interactions between different strains of the parasite and host macrophages: innate immune cells that paradoxically both serve as a niche for parasite replication and defend the host against parasite infection. Chapter 1 introduces Toxoplasma, the immune response to infection, and discusses the role of known parasite effectors. Experiments described in Chapter 2 identify a novel secreted parasite factor, GRA25, which modulates cytokine secretion in macrophages and controls parasite virulence in mice. In Chapter 3, high throughput methods are used to characterize the transcriptional and phosphorylation landscape of macrophages infected with different Toxoplasma strains. These analyses demonstrate that a secreted polymorphic tyrosine kinase, ROP16, directs murine macrophage polarization towards an alternatively activated phenotype. They also reveal that Toxoplasma parasites activate the Type I interferon response, a response classically associated with cytosolic pathogens. Chapter 4 describes work demonstrating that Toxoplasma strain-specifically modulates the innate immune response via secretion of a parasite factor, MAF1, which recruits host mitochondria to the parasitophorous vacuole. Finally, Chapter 5 discusses the future directions and implications of this work in the broader context of host-pathogen interactions.

"Completely updated and expanded, 'Emans, Laufer, and Goldstein's Pediatric and Adolescent Gynecology', Sixth Edition, covers the medical and surgical approaches to common pediatric and adolescent clinical problems. The book discusses the importance of the history and physical examination and the physiology of puberty and its associated disorders and complications"--Provided by publisher.

Innovations in catheterization techniques and embolization agents have considerably contributed to the development of endovascular occlusion techniques in arterial and venous trunks as much as distal parenchymal capillar beds. Mini invasive therapies, endovascular embolization and chemo-embolization now constitute valuable therapeutic alternatives in various fields: on a purely palliative or on a curative basis in oncology, but also in traumatology, functional diseases, and for the treatment of benign tumors, or when dealing with post-operative complications. As in-depth and detailed descriptions of these techniques are all ready available in specialized books, our ambition is to provide a basic handbook for the young vascular radiologists in training and a checklist for the more experienced interventional radiologists, by providing for each of the constantly increasing indications a synthetic approach of the technique and its expected results. The first part of this book relates to the tool box (the materials) and the procedure techniques as well as the physiopathological requirements for carrying out embolization; the second part is an analytical description of the main situations and anatomo-clinical strategies. This handy book should to be a valuable memory aid for clinicians and interventional radiologists, readily available in the multidisciplinary staff rooms and in angiography suites.

How does an embryo form? -- How do the placenta and fetal membranes form? -- The body cavities and the diaphragm -- The integumentary, skeletal, and muscular systems -- The respiratory system -- The cardiovascular system -- The digestive system -- The urinary system -- The reproductive system -- The nervous system -- Development of the head and neck, the eye, and the ear.

This book describes the use of telecommunication technologies to provide mental health services to individuals in communities or locations that are underserviced, typically as a result of their geographic isolation or due to cultural and/or linguistic barriers. The potential of the e-Mental Health approach is demonstrated in various mental health settings by describing concrete clinical examples and applications involving novel strategies for employing technology. Further, the book presents an approach to cooperation on a global level based on the exchange of expertise and knowledge across national boundaries. The target audience includes mental health workers (clinicians and staff members), medical and nursing students, academic researchers, technology professionals and health care policy makers.

This comprehensive guide answers commonly asked questions about neurosurgical conditions related to brain and spinal cord. Emergency Approaches to Neurosurgical Conditions fills the gap which arises after a diagnosis is made on the loved one, explaining the basics of neurosurgical diseases and their management. Emergency Approaches to Neurosurgical Conditions concentrates on the brain and spine, both in surgery and radiotherapy, as well as congenital and accident-related conditions. This comprehensive book which is part of a book-set including Comprehensive Guide to Neurosurgical Conditions, informs the reader on various symptoms to look for, and helps with the management of brain and spine surgery in chapters written by reputed neurosurgeons to help the physicians, the patients and their families.

Emergency Medical Services: Clinical Practice and Systems Oversight is the official textbook of the National Association of EMS PhysiciansTM (NAEMSPTM) National EMS Medical Directors Course and PracticumTM. Now paired with a companion website featuring self-assessment exercises, audio and video clips of EMS best practices in action, and more, this essential study aid guides students through the core knowledge they need to successfully complete their training and begin their careers as EMS physicians. Emergency Medical Services: Clinical Practice and Systems Oversight consists of: Volume 1: Clin.

Be prepared to manage increasingly prevalent problems seen in the ED, such as emergent complications of fertility treatment and management of patients who have had bariatric surgery. Deliver high-quality care to your younger patients with expanded pediatrics content. Stay up to date with new chapters on Clotting Disorders and Hemophilia, Patient-Centered Care, Health Disparities and Diversity in Emergency Medicine, Cost-Effectiveness Analysis, Antibiotic Recommendations for Empirical Treatment of Selected Infectious Diseases, and Cardiac Emergency Ultrasound: Evaluation for Pericardial Effusion & Cardiac Activity.

"This book is written and designed to provide medical educators in emergency medicine with resource for integrating medical simulation into their teaching practices. Material is provided in the form of clinical cases which are drawn from a diverse group of faculty authors from a range of major teaching centers. The cases provide readers with a full spectrum of pathology. Moreover, each case is formatted and annotated so that it can be tailored to novice or advanced learners, and easily deployed in a diversity of settings. Valuable "tips or tricks" accompany images patient data. Overall, this book is deal for use by EM educators as part of a tailored teaching and assessment portfolio"--Provided by publisher.

This book is a practical guide to the radiologic evaluation of acute musculoskeletal injuries of the upper and lower extremities in children. It covers the detection of more subtle and frequently missed fractures and injuries such as buckle fractures, Salter Harris I and II fractures, and epiphyseal and metaphyseal fractures. It also emphasizes the assessment of soft tissues and periarticular fat pads, which can lead to discovery of the sites of bony injuries. Other pathologies that affect the musculoskeletal system, such as infections and tumors, are also discussed. It includes over 600 magnetic resonance, computed tomography, ultrasound, and radiographic images organized by anatomic region.

Emergency Orthopedics is a practical, up-to-date, and comprehensive manual on the diagnosis and treatment of emergency injuries and disorders of the locomotor system. Its problem-based structure, with each chapter addressing a particular symptom, is designed to allow the reader to rapidly locate hands-on advice. For each symptom, facts and findings that will assist in diagnosis are highlighted. Possible diagnoses are suggested according to the ICD-10 code, and the proposed treatment recommendations consider both short- and long-term aspects. The text is supported by exceptionally instructive illustrations, e.g., of examination techniques and reduction maneuvers. The author has extensive practical experience in emergency rooms as well as in sports medicine, research, and education. This book will be a treasure trove of information for all who work in the emergency room and will also be very useful for general practitioners, physiotherapists, and chiropractors.

Text is specifically designed to help fine-tune emergency radiographic interpretation and problem-solving abilities. Illustrated with hundreds of high-resolution images, this reference covers the full range of clinical problems in which radiographic studies play a key role. Tha author takes you step-by-step through the radiographic analysis of medical, surgical, and traumatic disorders, giving you an unparalleled review of the use and interpretation of radiographic studies in emergency diagnosis.

The term "acute abdomen" refers to a serious, often progressive clinical situation that calls for immediate diagnostic and therapeutic action. Today, diagnosis via imaging has basically replaced the physical examination in the emergency room and the Radiologist has become of primary importance in this setting. However, close co-operation among the various specialists involved is essential for successful patient management, and thus the Radiologist needs to have a full understanding of the imaging modalities and technical skills required, as well as appropriate clinical knowledge of t

This manual explains how to make the right decisions on the timing and selection of investigations and surgical procedures in emergency and urgent surgical settings and describes the most widely used procedures step by step with the aid of high-quality illustrations. The goal is to address the situations that can arise in almost any emergency department throughout the world, enabling the surgeon on call to acquire or sharpen the knowledge and skills needed to deal with acute surgical problems in the most appropriate way. The reader will gain a sound understanding of the most efficient diagnostic modalities, pre-, intra-, and postoperative decision-making, and surgical techniques and issues in particular circumstances. The manual stems from an initiative by members of the European Society of Trauma and Emergency Surgery (ESTES) and the American Association for the Surgery of Trauma (AAST) to set up and formalize Emergency Surgery Courses to provide specific training in emergency and acute care surgery. It represents a didactic accompaniment to the course that will guide the beginner and maintain a certain degree of standardization among the more experienced.

The role of HLA in MS susceptibility and phenotype -- Sex-based differences in multiple sclerosis (Part I): biology of disease incidence -- Sex-based difference in multiple sclerosis (MS): Part II: rising incidence of multiple sclerosis in women and the vulnerability of men to progression of this disease -- The role of environment and lifestyle in determining the risk of multiple sclerosis -- Evidence for an association between Vitamin D and multiple sclerosis -- Photoimmunology and multiple sclerosis -- Modelling MS: chronic-relapsing EAE in the NOD/Lt mouse strain -- Developing biomarkers for MS -- Helminth Therapy for MS -- Self-assembling peptides form immune suppressive amyloid fibrils effective in autoimmune encephalomyelitis -- Index.

Neuro-oncology is one of the most exciting and rapidly evolving areas of oncology. In recent years there has been a remarkable increase in activity in the field, from basic science through to the clinic. This is reflected by advances in the understanding of the biology of CNS malignancies which have informed the development of novel and successful therapies. In this environment it is essential to facilitate communication and understanding of new ideas and concepts. Emerging Concepts in Neuro-Oncology is written with this in mind: to encourage collaboration across traditional boundaries and promote translational research for patient benefit. The book moves from concepts in the scientific basis of neuro-oncology in part one, through models of brain cancer in part two, to emerging concepts in clinical practice in part three, with a focus on translational research. This book will be an essential read for neuroscience researchers, cancer researchers, neurosurgeons and clinical oncologists as well as anyone with an interest in this exciting, dynamic field.

A global perspective on the management and prevention of emerging and re-emerging diseases Emerging infectious diseases are newly identified or otherwise previously unknown infections that cause public health challenges. Re-emerging infectious diseases are due to both the reappearance of and an increase in the number of infections from a disease that is known, but which had formerly caused so few infections that it was no longer considered a public health problem. The factors that cause the emergence or re-emergence of a disease are diverse. This book takes a look at the worl

Store-operated calcium (SOC) entry and channel play a central role in regulating intracellular calcium concentrations in a variety of cell types. SOC is critical for many physiological processes, most notably activation of the immune system, where its lack of function is known to cause severe combined immunodeficiency (SCID) in human patients. In lymphocytes, where SOC has been extensively studied, it has been shown that SOC is mediated by the calcium channel Orai that is activated by its direct binding to STIM, a calcium sensor localized in the endoplasmic reticulum. While it was previously thought that SOC serves an important role only in immune and non-excitable cells, it is now clear that SOC and the proteins that regulate its function are ubiquitously expressed in variety of tissues, including muscle and the nervous system, and serve a diverse set of biological functions. More recently, SOC has been shown to act in a several pathological processes, ranging from muscular dystrophy to cancer, underscoring the significance of gaining a better understanding of its mechanism of action. Here we set out to develop pharmacological blockers of SOC, in order to gain insights into its molecular mechanism and physiological role. Such blockers could allow for acute inhibition of SOC, allowing for a temporal control that is essential for mechanistic studies. If successfully developed, such reagents could also be of therapeutic use as immunosuppressants or anti thrombotic agents in human patients. We designed a novel methodology for generating SOC blockers based on the identification and targeting of minimal functional domains (MFDs) of STIM and Orai. Using this approach, we identified small molecule blockers that can inhibit SOC at high nanomolar concentrations and can also block T cell activation in vitro and in vivo. These studies not only provide an important set of tools for better understanding STIM and Orai function, but also identify compounds that could potentially be developed into therapeutic agents for the treatment of pathological conditions such as autoimmune disease.

For decades, Emery & Rimoin's Principles and Practice of Medical Genetics has provided the ultimate source for practicing clinicians to learn how the study of genetics can be integrated into practice. With advances in high-throughput technologies propelling the closer integration of lab and clinical work, this sixth edition bridges the gap between high-level molecular genetics and individual application. This comprehensive yet practical resource emphasizes theory and research fundamentals related to applications of medical genetics across the full spectrum of inherited disorders.

Master the genetics you need to know with the updated 14th Edition, by Drs. Peter Turnpenny and Sian Ellard. Review the field's latest and most important topics with user-friendly coverage designed to help you better understand and apply the basic principles of genetics to clinical situations. Learning is easy with the aid of clear, full-color illustrative diagrams, a wealth of clinical photographs of genetic diseases, multiple-choice and case-based review questions, end-of-chapter summaries, and convenient.

"Marion Allsopp maps the emergence of a powerful psycho-social idea out of its historical and social circumstances, as the concept of injury or trauma has moved, over the twentieth century, from the description of a physical, visible lesion to a more abstract, psychic harm -- often thought of as an 'invisible wound'. She looks at examples of this 'inward turn' in different academic, professional and administrative contexts in the Anglophone world: US psychiatry; UK tort law; Child Protection and the psychological/psychotherapeutic world of attachment theory, both of which span the Atlantic. How have 'psy' academics and professionals, with all their varied theories and techniques of intervention, contributed to the making of new ideas about an injured inner space? How have they explored the psychic interior; what are the emerging fields of knowledge and political conditions which facilitated the growth of this problem category of psychic harm, creating new claims to injury and new forms of state and non-state power? This mapping is not a description of a march towards some inexorable truth. On the contrary, by showing the ideas ' historical or contingent nature, it questions the inevitability of our 21st century present, in which the concept of psychological harm is so pervasive and taken for granted." -- [Publisher-supplied data]

This book describes different kinds of psychological, physical and sexual maltreatment and explains their possible consequences, especially as regards quality of life, psychopathology and sexual life. The focus is specifically on the victims of abuse, who are among the more frail and vulnerable members ofsociety. The book examines the impacts of maltreatment of both children and social minorities, such as homosexuals and gender dysphoric individuals or those affected by disabilities and describes skills that are of value in supporting victims of maltreatment and preventing discrimination. The work will be useful to sexual medicine specialists, medical doctors, psychologists and psychiatrists, as well as graduate students in these disciplines. By fostering a better understanding of discrimination triggers and effects, it will help clinicians to provide improved support through the tailoring of therapies to the needs of maltreated individuals.

"Of blacke cholor, without boyling" -- An impatient war -- "Will you turn me out if I can't get better?" -- Prevention is the cure -- "A distorted version of our normal selves" -- The fruits of long endeavors -- Atossa's war.

"This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The survey continued to document the prevalence of high-deductible health plans associated with a savings option and included questions on wellness benefits and health risk assessments. The 2010 survey included 3,143 randomly selected public and private firms with three or more employees (2,046 of which responded to the full survey and 1,097 of which responded to an additional question about offering coverage). Researchers at the Kaiser Family Foundation, the National Opinion Research Center at the University of Chicago, and Health Research & Educational Trust designed and analyzed the survey"--Website.

The role of atomistic modeling of molecules and organic compounds in biology and pharmaceutical research is constantly increasing, providing insights on chemical and biological phenomena at the highest resolution. To achieve relevant results, however, computational biology has to deal with systems containing at least 1000 atoms. Such big molecules cause large computational demands and impose limitations on the level of theory used to describe molecular interactions. Classical molecular mechanics based on various empirical relationships has become a workhorse of computational biology, as a practical compromise between accuracy and computational cost. Several decades of classical force field development have seen many successes. Nevertheless, more accurate treatment of bio-molecules from first principles is highly desirable. Hartree-Fock (HF) and density functional theory (DFT) are two low-level ab initio methods that provide sufficient accuracy to interpret experimental data. They are therefore the methods of choice to study large biological systems. Recently DFT has been applied to calculate single point energy of a solvated Rubredoxin protein. The system contained 2825 atoms and required more than two hours on a supercomputer with 8196 parallel cores. This study clearly demonstrates the scale of problems one has to tackle in first principles calculations of biologically relevant systems. Dynamical simulations requiring thousands of single point energy and force evaluations therefore appear to be completely out of reach. This fact has essentially prohibited the use of first principles methods for many important biological systems. Fortunately, the computer industry is evolving quickly and novel computing architectures such as graphical processing units (GPUs) are emerging. The GPU is an indispensable part any modern desktop computer. It is special purpose hardware responsible for graphics processing. Most problems in computer graphics are embarrassingly parallel, meaning they can be split into a large number of smaller subproblems that can be solved in parallel. This fact has guided GPU development for more than a decade; and modern GPUs evolved into a massively parallel computing v architecture containing hundreds of basic computational units, which all together can perform trillions of arithmetic operations per second. The large computational performance and low price of consumer graphics cards makes it tempting to consider using them for computationally intensive general purpose computing. This fact was recognized long ago and several groups of enthusiasts attempted to use GPUs for non-graphics computing in the early 2000's. One of the few successes from these attempts is now known as Folding@Home. These early attempts were primarily stymied by three major problems: lack of adequate development frameworks, limited precision available on GPUs, and the difficulty of mapping existing algorithms onto the new architecture. The two former impediments have been recently alleviated by the introduction of efficient GPU programming toolkits such as CUDA and the latest generation of graphics cards supporting full double precision arithmetic operations in hardware. These advances led to an explosion of interest in general purpose GPU computing and led to the development of many GPU-based high performance applications in various fields such as classical molecular dynamics, magnetic resonance imaging, and computational fluid dynamics. Most of the projects, however, lie far outside of quantum chemistry which is likely caused by the complexity of quantum chemistry algorithms and the associated difficulty of mapping them onto the GPU architecture. Various specific features of the hardware require complete redesign of conventional HF and DFT algorithms in order to fully benefit from the large computational performance of GPUs. We have successfully solved this problem and implemented the new algorithms in TeraChem, a high performance general purpose quantum chemistry package designed for graphical processing units from the ground up. Using TeraChem, we performed the first ab initio molecular dynamics simulation of an entire Bovine pancreatic trypsin inhibitor (BPTI) protein for tens of picoseconds on a desktop workstation with eight GPUs operating in parallel. Coincidently, this was also the first protein ever simulated on a computer using the classical molecular mechanics approach. BPTI binds to trypsin with a binding free energy of approximately 20 kcal/mol, making BPTI one of the strongest non-covalent binders. It vi is even more remarkable that a single BPTI amino acid LYS15 contributes half of the binding free energy by forming a salt bridge with one of the trypsin's negatively charged residues inside the binding pocket. In fact, the LYS15's contribution to the overall binding energy is approximately twice as large as what would be expected based on experimental measurements of salt bridge interactions in other proteins. Our simulation of BPTI demonstrated that substantial charge transfer occurs at the proteinwater interface, where between 2.0 and 3.5 electrons are transferred from the interfacial water to the protein. This effect decreases the net protein charge from +6e as observed in gas-phase experiments to +4e or less. We demonstrate how this effect may explain the unusual binding affinity of the LYS15 amino acid.

Foundation topics. Biology of aging / Teresa Dolinar. The history and demography of aging in the United States / Gail E. Souare, Linda S. Lloyd. Cultural diversity among elders in the US : meeting the challenge of the ethnogeriatric imperative / Gwen Yeo. Legal aspects of aging / Janet L. Lowder ... [et al.] The participation of cognitivelly impaired elderly in research / Sana Loue -- Topics in aging and public health.

This is the first comprehensive English language work to assemble information covering all Greek and Latin natural science, from its beginnings with Thales through the end of the Late Antiquity with Isidore of Seville and Paulos of Aigina. A team of over 100 of the world's experts in the field have compiled almost 1600 entries - 244 of those describing figures that are not mentioned in any other reference work - resulting in a unique and hugely ambitious resource which will prove indispensable for anyone seeking the details of the history of ancient science.

"This encyclopedia advances the understanding of behavioral medicine principles and clinical applications among researchers and practitioners in medicine, psychology, public health, epidemiology, nursing, and social work. In addition, the encyclopedia provides useful synergies for sociologists, anthropologists, and undergraduates with some interest in the interface of human health and behavior. Areas covered include quality of life and lifespan issues; population, health policy, and advocacy issues; health promotion and disease prevention; behavioral care in all types of settings; biological, psychological, and person factors in health behavior change; professional development and practice-related issues; and much more. This encyclopedia is the first resource to which readers turn for factual, relevant, and comprehensive information to aid in delivering the highest quality services."--Publisher's website.

The Encyclopedia of Biostatistics, 2nd Edition offers a reference to support the development and use of statistical methods for addressing the problems and critical issues that confront scientists, practitioners and policy makers engaged in the life and medical sciences.

This major reference work will break new ground as an electronic resource for students, educators, researchers and professionals. Encyclopedic in breath Child Behavior and Development will serve as a reference repository of knowledge in the field as well as a frequently updated conduit of new knowledge long before such information trickles down from research to standard textbooks. Child Behavior and Development will consist of three volumes divided by the major conceptual areas of child development: Learning, Behavior, and Emotions. Taking advantage of the techniques offered by the electronic medium, Child Behavior and Development will offer an extensive cross referencing system facilitating search and retrieval of information.

The Encyclopedia of Exercise Medicine is intelligently structured, easy accessible and user-friendly: A-Z format, clear, concise language and uniform essay structure as well as extensive cross references between keywords and related articles enables efficient searches in a user-friendly manner both for experts and newcomers. It is intended to be a comprehensive up-to-date data base on the adaptation of the human body to exercise and on the therapeutic use of exercise with up to 2,000 keywords. It covers all aspects within the full range of modern exercise medicine of each particular scientific discipline (cancer, parasitology, aging, etc.). This includes information on methodological approaches to measuring the principle components of motor fitness, and practical aspects of their enhancement by trainings regimes as well as by nutrition and the application of drugs. Such a wide range of entries, all written by leading experts in their respective fields, will therefore address both the basic/clinical scientist as well as the practitioner. Moreover, the Encyclopedia of Exercise Medicine is aimed at people in related fields, health care professionals, physiotherapists, trainers, students, informed athletes and interested laypersons. It is available both in print and as a fully searchable and hyperlinked electronic online edition.

In biochemistry, a metalloprotein is a generic term for a protein that contains a metal cofactor. The metal may be an isolated ion or may be coordinated with a nonprotein organic compound, such as the porphyrin found in hemoproteins. In some cases, the metal is co-coordinated with a side chain of the protein and an inorganic nonmetallic ion. This kind of protein-metal-nonmetal structure is seen in iron-sulfur clusters Metalloproteins deals with all aspects related to the intracellular and extracellular metal-binding proteins, including their structures, properties and functions. The biological roles of metal cations and metal-binding proteins are endless. They are involved in all crucial cellular activities. Many pathological conditions are related to the problematic metal metabolism. Research in metalloprotein-related topics is therefore rapidly growing, and different aspects of metal-binding proteins progressively enter curricula at Universities and even at the High School level on occasion. However, no key resource providing basic, but comprehensible knowledge on this rapidly expanding field exists. The Encyclopedia of Metalloproteins aims to bridge this gap, and will attempt to cover various aspects of metalloprotein/metalloproteomics and will deal with the different issues related to the intracellular and extracellular metal-binding proteins, including their structures, properties and functions. The goal is to cover exhaustively all catalytically and biologically crucial metal ions and to find at least one interacting protein for other metal ions. The Encyclopedia of Metalloproteins will provide a key resource for advanced undergraduate and graduate students, researchers, instructors, and professors interested in protein science, biochemistry, cell biology, and genetics.

This is the most comprehensive overview available anywhere on the broad, multi-faceted and complex topic of pain and the rapidly evolving scientific and medical disciplines that seek to understand, assess and treat pain. The second edition of theEncyclopedia of Pain is fully updated andhas been expanded by over 100 new essays. It includes more than 3,000 entries and provides clear, detailed and up-to-date coverage of the current state of research, and treatment of pain. In addition, detailed essays provide in-depth information on all aspects of nociception and pain, including substrates, causes, pathophysiology, symptoms and signs, diagnoses and treatment. More than 600 color figures enhance understanding of this too-little-understood topic. Solidly structured and inclusive, this reference is an invaluable tool for clinical scientists and practitioners in academia, health care and industry, as well as students, teachers and interested laypersons.

Public Health is one of the fastest growing university programs in the United States today. At the same time, the challenges that face the practitioner continue to grow and become more complex. This Encyclopedia of Primary Prevention and Health Promotion, 2nd ed covers more than 250 topics, taking a lifespan approach to the fields of public health and prevention. The encyclopedia is divided into four volumes: 1. Foundational Topics 2. Early Childhood and Childhood 3. Adolescence 4. Adulthood and Older Adulthood Within each volume, issues of illness prevention and health promotion (sometimes referred to as "positive psychology") are addressed in chapter-length entries arranged alphabetically. An international group of contributors synthesizes research focusing on improving the physical and mental health of the community as a whole. Each entry will have a structured format: Introduction, Definition of Terms, Prevalence, Theories, Empirical Studies, and Strategies (What Works, What Is Promising, What Doesn't Work). Each entry concludes with a look ahead to the coming decades of Public Health - what are the next steps to primary prevention and health promotion - and a "See Also" box recommending books, films, or articles by the editors for further reading. The encyclopedia is designed for practitioners, students, and researchers working in prevention, public health, and psychology. It will also serve as reference for practitioners in sociology, social work, nursing and medicine. The second edition more than doubles the number of entries in the first edition by adding entries focusing on gender, African American and Latino issues, social support, social and emotional learning, and physical health and disease. All entries from the first edition will be rewritten and expanded, reflecting the most up to date thinking in the field.

Offers a definitive and intellectually rigorous collection of psychological interpretations of the stories, rituals, motifs, symbols, doctrines, dogmas, and experiences of the world's religious and mythological traditions.

"From one of the world's foremost physicians and researchers, a monumental work that radically redefines our conventional conceptions of health and illness to offer new methods for living a long, healthy life. After considering the discoveries that have led to progress in treating some diseases, Dr. David B. Agus asked an essential question: Why aren't we better at curing illnesses like cancer? Based on his groundbreaking research and the clinical trials he has conducted at the nation's leading medical centers, he came to the realization that we've been approaching medicine from a faulty perspective, and the best way to prevent and combat maladies like cancer, heart disease, autoimmune disorders, and neurodegeneration is to first embrace a totally new view of the human body. What Is Health? asks readers to reconsider everything they think they know about health--and give up believing many myths that may actually be causing them harm and decreasing longevity. These myths revolve around a spectrum of misconceptions, from the benefits of vitamins and supplements to the role of DNA in one's fate. In attempting to reduce our understanding of ailments to a mutation, germ, or deficiency, Dr. Agus proves we have forgotten that the body is a complex system. He presents a systemic picture of the body's vast mechanisms that drive it either toward or away from sickness, empowering readers to take charge of their individual health in very personal, customized ways they've never imagined before. Along the way, Dr. Agus offers insights and access to breathtaking and powerful new technologies that promise to transform medicine in our generation. He also shows that there is no "right" answer in health decisions. This is a radically different approach that will not only change how we care for ourselves, but also how we develop the next generation of treatments and cures. What Is Health? represents a dramatic departure from orthodox thinking that promises to revolutionize our quest for long, healthy lives"-- Provided by publisher.

People with advancing neurological disease face increasing physical symptoms, along with psychosocial and spiritual issues affecting both themselves and their families and carers. There is increasing awareness that the end of life in neurological disease can be anticipated and recognised, taking into account certain key features of disease progression, and the associated issues can be addressed. The individual can prepare for future changes in their health, and be in a stronger position to influence or direct the care they receive. End of Life Care in Neurological Disease encourages health and social care professionals to become closely involved in the care of these people and their families, to maintain and maximise quality of life and plan ahead. This book addresses the principles and practice of end of life care for neurological disease, is written with a clinical, multidisciplinary focus, and is enriched with detailed case studies. This book is an accessible text for the multidisciplinary team in specialist palliative care, and will also be of interest to healthcare professionals in neurological services, including neurologists and neurology specialist nurses, rehabilitation services, general practitioners and community nurses. As care professionals, we are in a powerful position to help those who are living with advanced neurological disease and improve their quality of life and death.

"At the turn of the twentieth century, smallpox claimed the lives of two million people per year. By 1979, the disease had been eradicated and victory was declared across the globe. Yet the story of smallpox remains the exception, as today a host of deadly contagions, from polio to AIDS, continue to threaten human health around the world. Spanning three centuries, The End of Plagues weaves together the discovery of vaccination, the birth and growth of immunology, and the fight to eradicate the world's most feared diseases. From Edward Jenner's discovery of vaccination in 1796, to the early nineteenth-century foundling voyages in which chains of orphans, vaccinated one by one, were sent to colonies around the globe, to the development of polio vaccines and the stockpiling of smallpox as a biological weapon in the Cold War, world-renown immunologist John Rhodes charts our fight against these plagues, and shows how vaccinations gave humanity the upper hand. Today, aid groups including the Bill and Melinda Gates Foundation and the World Health Organization have made the eradication of polio a priority, and Rhodes takes us behind the scenes to witness the hard-fought battles of scientist, philanthropists, volunteers, and more, and how soon we may be celebrating the eradication of a second infectious disease, polio"--Provided by publisher.

Endocannabinoids and monoamines: modulating the modulators -- Endocannabinoid-mediated synaptic plasticity -- Current cannabinoid receptor nomenclature and pharmacological principles -- Cue-elicited craving for cannabis activates the reward neurocircuitry associated with the neuropathology of addiction -- Cannabinoid modulation of dopaminergic circuits in neurodegenerative and neuropsychiatric disorders -- Pathophysiology of mood disorders and mechanisms of action of antidepressants and mood stabilizers -- Anatomical, biochemical and behavioral evidence for cannabinoid modulation of noradrenergic circuits: role of norepinephrine in cannabinoid-induced aversion -- Gender Disparity of Depression: The Role of Endocannabinoids and Noradrenergic Function -- Endocannabinoids, Monoamines and Stress -- Chronic effects of cannabinoid drugs on monoaminergic systems and the role of endocannabinoids and cannabinoid receptors in human brain disorders -- Endocannabinoid Signaling and the Regulation of the Serotonin System -- Modulation of serotonin firing activity through CB1 agonists and FAAH inhibitors -- Involvement of serotonergic system in cannabinoid analgesia -- Cannabinoids, monoamines, COMT and schizophrenia: pathobiological mechanisms in psychosis.

There is currently considerable interest in the development of medicines that would enhance endocannabinoid-induced ℓ́ℓautoprotectionℓ́ℓ, for example through inhibition of endocannabinoid metabolizing enzymes or cellular uptake processes or that would oppose endocannabinoid-induced autoimpairment. This volume describes the physiology, pathophysiology and pharmacology of the endocannabinoid system and potential strategies for targeting this system in the clinic.

This volume updates its classic predecessor in both content and format. Written by two of the respected authorities in diagnostic endocrinology, it includes detailed information on how to perform and interpret those laboratory test procedures used to confirm the clinical diagnosis of the majority of known endocrine disorders. Newly designed, it provides a standardized format that makes it easier to access complete information about the diagnosis, screening, and management of traditional and newly perceived endocrine disorders. It provides sample calculations to assist with complex formulas as well as ICD-9 codes for all procedures.

Introduction to the endocrine system -- Endocrine function of the gastrointestinal tract -- Energy metabolism -- Calcium and phosphate homeostasis -- Hypothalamus-pituitary complex -- The thyroid gland -- The adrenal gland -- Life cycle of the male and female reproductive system -- The male reproductive system -- The female reproductive system -- Fertilization, pregnancy, and lactation.

Endocrine Emergencies: Recognition and Treatment offers a state-of-the-art update on the management of endocrine, diabetic, and metabolic emergencies. Developed by renowned experts, this comprehensive and easy to read title brings the field fully up to date, setting a high standard for diagnosis and treatment in each category. All chapters begin with a summary that presents, in concentrated form, what the physician needs to know to begin the evaluation and emergency treatment of the known endocrine emergencies. This is followed by an extended discussion of the pathophysiology that can be read after initial treatment has begun. Covering such areas as hypoglycemia, acute adrenal insufficiency, ovarian hyperstimulation syndrome, thyroid storm, and pituitary apoplexy, just to name several, Endocrine Emergencies: Recognition and Treatment is an invaluable, practical resource that will be of great interest to endocrinologists, internal medicine and emergency room physicians, fellows and residents.

This book is one of the first to evaluate the role of Steroids in autoimmune rheumatic diseases from the basic mechanisms to the clinical involvements and focuses on the importance of steroidal hormones in the pathogenesis and therapeutical management of the autoimmune rheumatic diseases. In particular, the chapters analyze the mechanisms of action and the involvement of adrenal steroids (glucocorticoids) in the neuroendocrine immune system, including the effects on elderly. The perturbations of the HPA axis as source of altered steroidal sythesis will be discussed and related to some interesting pathological conditions often complicating the autoimmune rheumatic diseases susch as psychosis or fibromyalgia. Concerning the role of gonadal steroids (sex hormones), several chapters will discuss clinical and epidemiological evidences of their role, as well as their effects as risk factors in autoimmune rheumatic diseases, including a section in Pediatrics. *The premier issue evaluating the role of Steroids in autoimmune rheumatic diseases from the basic mechanisms to the clinical involvements *Documents the latest research and indicate recent and coming new therapeutical-biological approaches to the therapy *The book will present therapeutical perspectives concerning the new glucocorticoids, and the effects of biological drugs on their synthesis.

This book provides comprehensive coverage of the fundamental concepts of hormone biological action. These concepts provide a solid foundation for understanding the physiologic mechanisms involved in neuroendocrine regulation of organ function. -- Publisher description

Continues the tradition of the Secrets Series®, offering fast answers to the most essential clinical endocrinology questions. The Q&A format includes pearls, tips, and memory aids to help you to learn and study efficiently. Provides a concise board review or handy clinical endocrinology resource.

Receptors and hormone action -- The hypothalamus and pituitary part I : the hypothalamus and posterior pituitary -- The hypothalamus and pituitary part II : the anterior pituitary -- The adrenal glands part I : the adrenal medulla -- The adrenal glands part II : the adrenal cortex -- The thyroid gland -- Hormonal control of reproduction part I : male reproductive system -- Hormonal control of reproduction part II : female reproductive system -- Hormonal control of reproduction part III : development and fertility -- Insulin and the regulation of plasma glucose -- Hormonal regulation of plasma calcium and calcium metabolism -- Miscellaneous hormones.

Endocrinology, and diabetes care in particular, is a dynamic field where clinicians must translate new evidence into clinical practice at a rapid pace. Designed in an engaging, case-based format, Endocrinology and Diabetes: A Problem Oriented Approach offers a wide range of thought-provoking case studies that reflect contemporary, challenging, hands-on clinical care. Further, by providing a list of specific clinical problems, this format offers the reader a more convenient and pointed way to solve precise clinical problems in a timely manner. Developed by a renowned, international group of experts, this comprehensive title covers the most common clinical problems in endocrinology and diabetes and should be of great interest to endocrinologists, diabetologists, internal medicine physicians, family physicians, fellows, and residents.

Understanding the influence and interaction between physical activity and the endocrine system are of paramount importance in dealing with a multitude of health problems. In Endocrinology of Physical Activity and Sport, renowned physicians and researchers provide a comprehensive and expanded update on the scientific, clinical and practical components of endocrinology as related to sport and exercise. The authors thoroughly review what is known about how such activity affects the endocrine system and how in turn these hormonal responses affect many other organs and systems of the body. In addition, aspects of endocrinology in non-glandular tissue which have endocrine actions are addressed; for example, adipocytes and the release of leptin and related adipocytokines. Further, a wide range of clinically related topics such as athletic amenorrhea, osteopenia, sarcopenia, and hypogonadism are included. This new edition critically integrates what is known about the complex interaction of the endocrine system in the sports context and will again prove immensely valuable to all physicians and clinical investigators treating those active in sports today.

This book reviews the available information on bacterial disinfection in endodontics, with emphasis on the chemical treatment of root canals based on current understanding of the process of irrigation. It describes recent advances in knowledge of the chemistry associated with irrigants and delivery systems, which is of vital importance given that chemical intervention is now considered one of the most important measures in eliminating planktonic microbes and biofilms from the infected tooth. Recommendations are made regarding concentrations, exposure times, and optimal sequences. Possible complications related to the use of the different solutions are highlighted, with guidance on response. In addition, clinical protocols are suggested on the basis of both clinical experience and the results of past and ongoing research. Throughout, a practical, clinically oriented approach is adopted that will assist the practitioner in ensuring successful endodontic treatment.

Endodontic pain is a complex symptom that often drives a patient to a dentist in search of relief. In these circumstances, the patient is likely to pose a range of questions: Can you relieve my pain? Will the treatment be painful? How will I feel later? The answers to such questions often form the basis of the patient's assessment of the dentist. The combination of pain and a negative dental experience has physical and psychological sequelae for the patient that may last long after treatment. This book is a concise, well-structured guide to the assessment and treatment of patients who present with endodontic pain, in which step-by-step descriptions are complemented by informative images and flow charts. The advantages, disadvantages, and significance of specific diagnostic and treatment procedures are clearly described, as is a pharmacotherapeutic approach to the prevention and treatment of pain. In addition, the causes and biological basis of endodontic pain are explained and guidance is provided on further strategies for pain prevention. The crisp narrative, efficient design, and visual detail are notable features of this book that will make it an ideal chairside resource for the clinician and a dependable reference for the student.

Cardiovascular (CV) disease is the leading cause of death worldwide. While death rates from many acute CV illnesses have declined in developing countries, a substantial proportion of individuals with CV disease ultimately die from CV causes. As the population ages, the global burden of CV disease will continue to rise. Until recently, the focus of clinicians has been on saving lives and deferring death. Over the past decade there has been growing recognition of the importance of palliative care and end of life care in CV disease. While palliative and supportive care should be provided throughout the course of serious and life-shortening illnesses, this book focuses on issues that clinicians encounter in end-of-life care. This book provides guidance to clinicians working across the breadth of care settings, in chronic progressive disease as well as sudden arrhythmic death andwith advanced technologies. End-of-Life Care in Cardiovascular Disease is designed to assist clinicians, nurses, and other healthcare providers in addressing end of life care for patients with CV disease in a variety of common clinical scenarios. Each chapter is written by expert clinicians and researchers, and concisely reviews current knowledge and recommendations for providing patient- and family-centered end-of-life care.

Introduction -- Chapter 1. Multinational Perspectives on End-of-Life Issues in the Intensive Care Unit -- The United States -- Canada -- New Zealand -- United Kingdom -- Communicating to family: the Israeli perspective -- Maria and the good death: the Latin American view -- The Greek perspective -- The South African perspective -- A perspective from India -- Japan -- Chapter 2. Critical Illness and End-of-Life Issues: A Global View -- An evaluation of international medical ethics at the end of life -- Communication in the Intensive Care Unit -- End-of Life issues in the critically ill: a global perspective -- Chapter 3. Death in a Lonely Place: Pathophysiology of the Dying Patient -- Chapter 4. The History of the Definition(s) of Death: From the 18th Century to the 20th Century -- Chapter 5. What It Feels Like to Live and Die on Prolonged Life Support -- Chapter 6. Who's in Charge in the Intensive Care Unit? -- Chapter 7. Dealing with Difficult Surrogates -- Erring on the side of autonomy -- Erring on the side of reason -- Healthcare providers' contribution to the problem of futility -- Chapter 8. Emotions in the Intensive Care Unit -- Chapter 9. The Role of Ethics Committees in End-of-Life Care -- Chapter 10. Medical Liability Issues in Dealing with Critical Care Patients in the End-of-Life Situation -- Chapter 11. End-of-Life Issues and United States Politics -- Chapter 12. Comments from Ancillary Healthcare Providers -- My experiences with end-of-life as a bedside-nurse -- A Chaplain's perspective -- Pharmacotherapy considerations during end-of-life care of critically ill adults -- Chapter 13. The Intensive Care Unit of the Future -- Afterword.

Current status of the prevention and early diagnosis of endometrial adenocarcinoma -- The value of endometrial cytology -- Techniques of endometrial cytology -- Techniques of endometrial histopathology -- New techniques for the diagnosis of endometrial pathology -- Cytology of the normal endometrium - cycling and postmenopausal -- Benign endometrial lesions -- Cytopathology of endometrial hyperplasias -- Cytopathology of endometrial adenocarcinoma -- Cytopathology of the non-epithelial malignant tumors of the uterine corpus.

Introduction -- Predisposing and protective factors of endometriosis -- Theories on endometriosis -- Oxidative stress and endometriosis -- Role of iron in the pathogenesis of endometriosis -- Role of environmental pollutants in endometriosis -- Endometriosis and ovarian cancer -- Endometriosis: impact on quality of life -- Diagnosis of endometriosis -- Management of endometriosis -- Concluding remarks.

Endometriosis is one of the most common gynecological diseases, causingpelvic pain, infertility, and cancer. The condition reduces the quality of life for the estimated 10% of menstruating women who are affected by it. This book provides a clear insight intothe pathogenesis and pathophysiology of endometriosis-essentialinformation forcliniciansintending to successfully treat the condition. The first part covers a range of topics including stem cells, NK cells, macrophages, inflammation, cytokines, epigenetics, prostaglandin, sex steroids, aromatase, apoptosis, nerve fibers, and malignant transformation to aid in understanding the pathogenesis and pathophysiology of the disease. The second part provides useful tools for therapy, specifically, notable recent techniques in prevention, imaging, biomarkers, medical treatments, surgical treatments, prevention of recurrence, and infertility treatments. Each chapter was written by an expert in the field, with nearly 40 researchers and clinicians contributing to the work. This book will be highly useful to clinicians as well as to research scientists who are interested in this enigmatic disease.

The Endoplasmic Reticulum (ER) is an organelle with extraordinary signaling and homeostatic functions. It is the organelle responsible for protein folding, maturation, quality control and trafficking of proteins destined for the plasma membrane or for secretion into the extracellular environment. Failure, overloading or malfunctioning of any of the signaling or quality control mechanisms occurring in the ER may provoke a stress condition known as âER stressâ. Accumulating evidence indicates that ER stress may dramatically perturb interactions between the cell and its environment, and contribute to the development of human diseases, ranging from metabolic diseases and cancer to neurodegenerative diseases, or impact therapeutic outcome. This book primarily focuses on the pathophysiology of ER stress. It introduces the molecular bases of ER stress, the emerging relevance of the ER-mitochondria cross-talk, the signaling pathways engaged and cellular responses to ER stress, including the adaptive Unfolded Protein Response (UPR), autophagy as well as cell death. Next the book addresses the role of ER stress in physiology and in the etiology of relevant pathological conditions, like carcinogenesis and inflammation, neurodegeneration and metabolic disease. The last chapter describes how ER stress pathways can be targeted for therapeutic benefit. Altogether, this book will provide the reader with an exhaustive view of ER stress biology and the latest insights in the role of ER stress in relevant human diseases.

This book covers pre-operative diagnosis and new techniques for dissecting early-stage gastric cancer. With abundant color figures and extensive explanations, it covers actual practice scenarios, including difficult-to-treat cases.

"Increasingly used as an adjunctive tool in the diagnosis and management of ear disease, middle ear endoscopy has the potential to decrease patient morbidity, prevent disease recurrence, and reduce costs. Its capacity to uncover hidden anatomy within the small dimensions of the ear has made it essential for functional surgery, allowing surgeons to preserve key anatomic structures such as the cochlea and facial nerve. Now for the first time, the physicians who pioneered this groundbreaking minimally invasive technique review its indications, advantages, disadvantages, and surgical approaches. Written by the foremost leaders in the field, all members of the International Working Group on Endoscopic Ear Surgery. Features nearly 1,000 intraoperative endoscopic images filmed with high-definition cameras, plus outstanding line drawings that aid in understanding all concepts. Comprehensively covers the field, including chapters on endoscopic and combined endoscopic-microscopic management of cholesteatoma, surgical restoration of middle ear ventilation, myringoplasty, Meniere disease, tympanoplasty and stapes surgery, revision surgery, and much more. Demonstrates state-of-the-art endoscopic procedures in 19 instructive videos. From the unique anatomy and pathophysiology of the middle ear through diagnosis, surgical indications, procedures, and instrumentation, this book is indispensable for all otolaryngologists and neurotologists. It offers a full picture of the field today, as well as exploring the future possibilities of ear endoscopes alone or in combination with operative microscopes for the most effective treatment of middle ear pathologies"--Provided by publisher.

Owing to the alterations in visceral anatomy, many endoscopists, and especially trainees, experience difficulties when performing endoscopic surveys or procedures in patients who have previously undergone surgery to the digestive tract. In this richly illustrated book, an expert in the field provides a detailed overview of endoscopic follow-up of gastrointestinal (esophageal, gastric, and colorectal) anastomosis. Both normal appearances and pathological conditions involving complications are fully covered. The methodology, timing, protocols, and role of diagnostic endoscopy are first discussed. Endoscopic treatments for the resolution of different clinical problems related to recurrences, stenoses, dehiscences, and fistulas are then evaluated step by step with the aid of high-quality images. Regardless of level of experience, endoscopists and gastroenterologists will find Endoscopic Follow-up of Digestive Anastomosis to be an invaluable source of information and aid to treatment in this important area, which too often receives insufficiently detailed attention.

"As the understanding of human physiology has become more complete, the importance of preserving normal tissues has become increasingly clear in the field of surgery. This understanding gave birth to the concept of minimally invasive surgery that has conquered almost all surgical fields, including spine surgery. With recent advances and experience, minimally invasive spinal surgery (MISS) is gradually replacing conventional spine surgical procedures. The primary goal of MISS is to achieve outcomes comparable to those of open surgery while minimizing normal tissue damage and reducing recovery times. Advances in optics, radionavigation, and laser technology made MISS more accessible to surgeons and truly less invasive for the patient. Minimally invasive surgical techniques have touched the entire spinal column, from the cervical to the lumbosacral spine. The MISS spectrum ranges from simple disk surgeries to the most complicated spine surgeries, such as deformity correction. Of all MISS procedures, percutaneous endoscopic disk surgery has attracted the most attention from the global spine surgery community and has enjoyed phenomenal advances in sophistication in the past decade. The remainder of the chapter presents a historical account of percutaneous disk surgeries for the lumbar and cervical spine. "--Provided by publisher.

This manual covers all aspects of endoscopic surgery of the lacrimal drainage system. Step-by-step descriptions are provided of endoscopic dacrocystorhinostomy (DCR) and its use in revision surgery, accompanied by numerous helpful photographs and anatomical drawings. In addition, clear flow charts are included to aid in diagnostic and surgical decision making and identify surgical indications. Essential information is provided on anatomy, physiology, and pathology, and an individual chapter is devoted to imaging of the lacrimal drainage system. Further topics include lacrimal probes and stents, potential complications of surgery, and endoscopic DCR in the pediatric age group. This book will assist the practitioner in negotiating the steep learning curve involved in gaining the skills needed to perform endoscopic surgery of the lacrimal drainage system, which offers significant advantages in terms of avoidance of external incisions and maintenance of the lacrimal pump.

This volume reviews the history of endoscopy to diagnose small bowel disorders, places other diagnostic modalities into perspective, and defines the role of capsule endoscopy and per overtube assisted and retrograde enteroscopy in disorders as disparate as gluten sensitive enteropathy, small bowel neoplasms, and inflammatory bowel disease. The book further details the nonoperative approach to NSAID strictures, foreign body retrieval (to include impacted capsule endoscopes), and the diagnosis and treatment of chronically bleeding angiodysplastic lesions. The text is also richly illustrated with over 150 images and includes online video segments. Written by experts in the field, Endoscopy in Small Bowel Disorders is a valuable resource for medical and surgical residents, gastroenterologists in training and practice, therapeutic endoscopists, and general and colorectal surgeons.

The purpose of this book is to improve diagnostic yields of capsule endoscopy and double-balloon endoscopy, because those procedures can depict nonspecific findings that may not lead to a proper diagnosis. Another reason for the publication was recognition of the difficulty in distinguishing enteroscopic findings of ulcerative colitis from those of Crohn's disease. From a practical point of view, it is important to observe endoscopic pictures first, then to compare the images of other modalities, and finally to compare macroscopic pictures of resected specimens. For that reason, a large number of well-depicted examples of small intestinal lesions were assembled to clarify differences among small intestinal lesions that appear to exhibit similar findings and morphologies. Comparisons with radiographic findings comprise another important element in diagnosis. There are limitations in endoscopic observations of gross lesions of the small intestine, with its many convolutions. In Japan, many institutions still practice double-contrast imaging, which provides beautiful results. Because a single disorder may exhibit variations, this volume includes multiple depictions of the same disorders. Also included are lesions in active and inactive phases, as both appearances are highly likely to be encountered simultaneously in clinical practice. The number of illustrated findings therefore has been limited to strictly selected cases.

From diagnostic to therapeutic procedures, Endosonography, 3rd Edition is an easy-to-access, highly visual guide covering everything you need to effectively perform EUS, interpret your findings, diagnose accurately, and choose the best treatment course. World-renowned endosonographers help beginners apply endosonography in staging cancers, evaluating chronic pancreatitis, and studying bile duct abnormalities and submucosal lesions. Practicing endosonographers can learn cutting-edge techniques for performing therapeutic interventions such as drainage of pancreatic pseudocysts and EUS-guided anti-tumor therapy. Meticulous updates, electronic access to the fully searchable text, videos detailing various methods and procedures-and more-equip you with a complete overview of all aspects of EUS. Get a clear overview of everything you need to know to establish an endoscopic practice, from what equipment to buy to providing effective cytopathology services.

Endotext (Endotext.org) is an online resource on endocrine disease written by physicians and directed toward physicians around the world caring for patients with these problems. It is organized by Leslie J De Groot, MD, twelve section editors, and nearly 400 authors. It is comprehensive, authoritative, constantly updated, and unbiased. Endotext, covering the broad area of Clinical Endocrinology, emphasizes clinical endocrine practice and includes the most current information on the manifestations of endocrine disease, diagnosis, and treatment.

"Despite the "hot topic" status of this subject, there are few book-length resources that cover the subjects presented here in any depth. There is a particular need for high-quality coverage of hybrid techniques, which have emerged only over the last 3-4 years. Some of the techniques/procedures covered in this book have gained approval and are being used in patient care in Europe and elsewhere and are sure to see approval soon in the United States. Thus, this book not only fills a current need, but also anticipates a very likely near-term need amongst its target audience. The book aims to be a clear, practical guide to the topics covered, and with its combination of text with high-quality still images and videos presented on a companion website it should more than meet the expectations of buyers looking for expert guidance in this area"--Provided by publisher.

Endovascular neurosurgery is a recently introduced but rapidly evolving medical field, which uses minimally invasive interventions to treat major life-threatening vascular lesions of the Central Nervous System. Although its history counts less than 15 years of worldwide acceptance, it has rapidly displaced the traditional open neurosurgical techniques, being nowadays the first treatment choice for brain aneurysms and vascular malformations. Thus, the experience of each neuroendovascular center and performer is invaluable, offering the base for learning and teaching the new generation of interventionalists as well as for the evolvement of the method itself. This book presents the basic principles of endovascular neurosurgery starting from clinical cases. Through this close-to-clinical-reality-process, the reader will be able to more thoroughly understand the pathophysiology of the brain and spine vascular lesions as well as the decision-making strategy, related to the indications, endovascular methods and results, finding suggestions and solutions to his/her clinical questions and problems. Besides chapters devoted to CNS vascular embryology and anatomy, clinical cases organized in groups based on the treated lesions are introduced: ruptured and unruptured cerebral aneurysms of the anterior and posterior circulation, side-wall and bifurcation aneurysms, arteriovenous malformations (AVM), dural arteriovenous fistulae (dAVF), arterial stenosis and angioplasty as well as spinal vascular lesions. A separate chapter is devoted to the organization and necessary equipment of the angio room and the department offering neuroendovascular service. This volume will be of interest to neurosurgeons, interventional neuroradiologists, vascular surgeons, neurologists and ICU physicians as well as health care providers who are involved in the diagnosis and management of the vascular lesions of the brain and spine.

In the 4th edition, Drs. Wesley S. Moore, Samuel S. Ahn, and a host of experts guide you through the latest developments in this innovative field. New procedures and special features, such as key points and case reviews, help illustrate effective patient care, and new topics such as endoscopic management of aneurismal disease and traumatic injuries review with you the latest endovascular surgical techniques. Broaden your surgical skills with new chapters on endoscopic management of aneurismal disease and traumatic injuries, and review a valuable new section covering the TIPS Procedure for Portal Hypertension, Anesthetic Management for Endovascular Procedures, the Use of Coil Embolization in Endovascular Surgery, and more. An in-depth, core reference on the best practices and techniques in endovascular surgery. Perfect for both the training vascular surgeon who needs a comprehensive view of endovascular surgery as well as a refresher on current techniques and optimal outcomes for the practitioner.

The gastrointestinal track provides one of the distinct systems where multiple malignancies, including adenocarcinoma of the pancreas, esophagus and colon are each associated with obesity. This unique association is covered in this volume of Energy Balance and Cancer from the epidemiologic, biologic and potential etiologic viewpoint. The focus on possible dietary contribution as well as the role of exercise in prevention and therapy is presented in both animal model and patient based studies. Special focus is provided also on the role of genetic mutations and inflammatory pathways as drivers of these obesity related gastrointestinal malignancies. Overall, this volume on Energy Balance and Gastrointestinal Malignancies should be valuable to Epidemiologists, Gastroenterologists and Oncologists, as well as to students and researchers from multiple disciplines interested in understanding and disrupting the association between obesity and cancer.

The obesity pandemic continues to increase on a world-wide basis with over 70% of the United States population being either overweight or obese. Hematologic malignancies have recently been identified among the obesity associated malignancies spanning the lifespan from childhood to the elderly and include leukemia, myeloma, lymphoma and others. In addition to the etiologic association between obesity and hematologic malignancies, the presence of obesity has profound effects on therapy by impacting pharmacokinetics of chemotherapeutic agents, dose, adipocyte metabolism and drug distribution. These may be particularly important in hematopoietic stem cell transplantation. Another important aspect of the association of obesity with hematologic malignancies is the increased incidence of obesity in children who successfully complete therapy for acute lymphoblastic leukemia. This and other observations indicate important relations between the hematopoietic systems and fat metabolism. This volume on Energy Balance in Hematologic Malignancies will provide an important volume in this series and a basis for better understanding etiology, mechanisms, therapeutics implications and experimental approaches. This volume of energy balance and cancer will focus on the relation of obesity to hematologic malignancies, the epidemiology, potential mechanisms, and thereapeutic considerations including effects on pharmacologic and physical approaches as well as the delayed effects of therapy on energy balance.

Evolution has selected for organisms that benefit from genetically encoded cell-cell communication. We observe cell-cell communication throughout every scale in nature, from simple single-celled bacteria to complex multicellular mammals. Engineers have begun to repurpose elements of natural communication systems to coordinate their own population-level behaviors, including oscillations and programmed pattern formation. Existing engineered systems, however, rely on small, system-specific biomolecules to send messages among cells. However, such molecules are capable of sending only a single message, typically "regulate transcription.'' Thus, the information transmission capacity of such biological communication systems is fundamentally limited. Through this thesis, I demonstrated the decoupling of messages from a common communication channel via the autonomous transmission of numerous arbitrary genetic messages. To do so, I engineered a cell-cell communication platform using bacteriophage M13 gene products to autonomously package and deliver heterologous DNA messages of varying lengths and encoded functions. Further, I increased the range of engineered DNA messaging across semisolid media by coupling message transmission or receipt to active cellular chemotaxis. Through this coupling, I demonstrated that our system is adaptable to different contexts by creating simple patterns. Finally, using recombinase-mediated logic gates developed within the Endy laboratory, I demonstrated the ability to program bacteria by transmitting logic gates to surrounding cells. Overall, this work significantly enhances the suite of cell-cell communication tools available to engineers. I have shown that a variety of DNA messages can be transmitted among cells and have moved the field of synthetic biology closer to designing synthetic ecologies with more complex communication schemes and varied behaviors.

Proteins and peptides are an incredibly versatile class of biological molecules, with a vast array of naturally occurring functions. In cancer, the natural roles of proteins become incorrectly regulated, and the presence of cancer-related proteins on tumor cells can be detected and targeted for diagnosis and treatment. This thesis decribes novel engineered peptides for molecular recognition of cell surface receptors expressed in cancers, and application of these engineered peptides as diagnostic agents to identify solid tumors in mouse models. For this work. three different cystine-knot peptides were used for development and engineering: Agatoxin (AgTx), Agouti-related protein (AgRP), and Ecballium elaterium trypsin inhibitor-II (EETI). In addition, two protein receptors were employed as model tumor targets relevant for molecular imaging of cancer: carbonic anhydrase IX (CA IX) and tumor associated integrin receptors. New methods were developed towards engineering AgTx and AgRP to bind CA IX, and work to produce these peptides for further study and their limitations are described. In a parallel line of research, to further understand the promise of using knottin peptides in cancer imaging, the influence of amino acid loops on tissue biodistribution was examined using engineered AgTx, AgRP, and EETI peptides that bind tumor target integrins in mouse xenograft models. Finally, an engineered EETI knottin peptide that binds tumor-associated integrins was shown to specifically target and illuminate brain tumors in mouse models of medulloblastoma. Importantly, the protein engineering methods and molecular imaging applications described here have promise for influencing the clinical outcome of cancer patients through image-guided surgical resection, disease staging and management, and monitoring the effectiveness of therapeutic treatments.

This book offers a comprehensive overview of current challenges and strategies to regenerate load-bearing and calcified human tissues, including bone, cartilage,tendon, ligaments and dental structures (dentin, enamel, cementum and periodontal ligament). Tissue engineering has long held great promises as an improved treatment option for conditions affecting mineralized and load-bearing structures in the body. Although significant progress has been achieved in recent years, a number of challenges still exist. Scaffold vascularization, new biofabrication methods (3D printing, lithography, microfabrication), peptide conjugation methods, interface engineering, scaffold mechanical properties, iPS cells, organs-on-a-chip, are some of the topics discussed in this book. More specially, in the first section readers will find an overview of emerging biofabrication methods. In section 2, applied strategies for regeneration of (2.1) bone, cartilage and ligament, as well as (2.2) dentin, cementum, enamel and periodontal ligament are discussed across 14 chapters. While other volumes have addressed the regeneration of individual tissues, or exclusively focused on different regenerative strategies, the focus of this work is to bring together researchers integrating backgrounds in materials sciences, engineering, biology, mechanics, fluidics, etc, to address specific challenges common to regeneration of several load-bearing and calcified tissues. Therefore, this book provides a unique platform to stimulate progress in the regeneration of functional tissue substitutes. We envision that this book will represent a valuable reference source for university and college faculties, post-doctoral research fellows, senior graduate students, and researchers from R&D laboratories in their endeavors to fabricate biomimetic load bearing tissues.

Polyketides are a large class of structurally diverse natural products which posses a wide range of biological activities. Unfortunately, despite the potential utility of these compounds in the clinic, large scale production of many of these natural products from their native hosts remains a challenge. Additionally, due to their complexity, engineering better pharmacokinetic properties by traditional synthetic means is often challenging. A better understanding of the biosynthetic machinery which produces polyketides allows for optimization of their production and paves the way for bioactivity-based pathway reengineering. This work begins with an introduction detailing attempts to unravel the biosynthetic underpinnings of two key natural product families, the tetracyclines and the thiostreptons, with an eye toward ultimately reengineering the pathways. Then, our efforts to reconstruct and reengineer the biosynthesis and biological activity of the type II polyketides frenolicin and A-74528 are detailed. Successful reconstruction of a chimeric biosynthetic pathway to frenolicin B and subsequent reengineering of that pathway to produce novel frenolicin analogs is described. Then, the biological activity of these compounds both in vitro against the parasites Toxoplasma gondii and Plasmodium falciparum is discussed. Additional studies against Plasmodium berghi in mice show that frenolicin B is an effective antiparastic agent in vivo. Following this, engineering of a biosynthetic pathway to the novel antiviral agent A-74528 from S. sp. SANK 61196 is presented and the impact of various tailoring enzymes on metabolite production are explored.

Recombinant proteins have been used widely in both basic research and biomedical applications including protein therapeutics and biomaterials. Many efforts have been devoted to the investigation of novel synthetic strategies for producing recombinant proteins for various applications, which is the focus of this dissertation. In the first section, a biosynthetic strategy was developed to produce collagenous proteins with post-translational modifications in E. coli. Collagen is the most abundant protein in human, and plays a dominant role in maintaining the biological and structural integrity. Recombinant expression of collagens and fragments of collagens is often difficult as their stability requires appropriate proline hydroxylation. Prolyl 4-hydroxylases (P4H) are ascorbate-dependent oxygenases that play key roles in collagen folding by catalyzing the post-translational hydroxylation of specific proline residues on target proteins to form (2S, 4R)-4-hydroxyproline. Thus far, the study of these post-translational modifications has been limited by the lack of a prokaryotic recombinant expression system for producing hydroxylated proteins. Unlike eukaryotic cells such as yeast and insect cells, bacterial cytoplasm cannot activate P4H, which requires an ascorbate co-factor that bacteria do not produce. By introducing a biosynthetic shunt to produce ascorbate-like molecules in E. coli cells that heterologously express human P4H, we have created a strain of E. coli that produces collagenous proteins with (2S, 4R)-4-hydroxyproline. Different levels of proline hydroxylation can be obtained by tuning culture conditions. We have verified that hydroxylation of collagenous materials produced in the new system leads to an increase in thermostability. Using this new system, we have observed hydroxylation patterns indicative of a processive catalytic mode for P4H that is active even in the absence of ascorbate. Our results provide insights into P4H enzymology, and create a foundation for better understanding how post-translational hydroxylation affects proteins. Further, we applied the novel E. coli expression system to produce a collagenous protein, adiponectin, which has many beneficial effects on obesity-related metabolic and cardiovascular disorders, and reverses insulin insensitivity. By introducing key post-translational modification enzymes to E. coli, we have endowed the expression system with capabilities of making necessary modifications on adiponectin for its correct assembly, and thus obtained biomimetic adiponectins. High-molecular weight (HMW) multimers of adiponectin have been obtained, and their biological activities of suppressing endothelial cell apoptosis have been confirmed with in vitro cell assays. In section 2, modular protein polymers have been created through genetic engineering and enzymatically crosslinked into hydrogels with tunable properties. The many challenges currently faced in regenerative medicine research require the development of new, modular biomaterial systems that can serve as scaffolds for cellular maintenance, expansion and growth, and which can be tuned by the user to mimic any necessary aspects of natural ECM to an optimal degree. Toward this goal, we have created a family of block co-polypeptides comprising amino acid sequence elements that allow mild enzymatic crosslinking into gels. These new families of protein polymers were designed to be linear, random coil, and contain either lysine or glutamine, which have the recognition substrates for transglutaminase (TG) crosslinking, evenly spaced along the protein backbone. Crosslinking occurred within two minutes upon the addition of TG under physiological conditions, as determined by particle tracking microrheology. The material properties of the gel can be tuned with the hydrogel composition to mimic cellular microenvironment of different tissues. Furthermore, in order to introduce biofunctionalities into the hydrogels, a versatile expression vector has been engineered that allows the insertion of bioactive protein domains into these block co-polypeptide. For example, a cell adhesion signal based on the RGD sequence from human fibronectin was incorporated. The RGD-containing hydrogel was successful in enhancing cell adhesion, and were also proven to be compatible with the culture of mesenchymal stem cells. The specific nature of these protein polymer precursors of the modular hydrogel composition allows tailoring of mechanical and biochemical properties, rendering these gels valuable for various tissue engineering applications.

Polymers have played a critical role in the rational design and application of drug delivery systems that increase the efficacy and reduce the toxicity of new and conventional therapeutics. Beginning with an introduction to the fundamentals of drug delivery, Engineering Polymer Systems for Improved Drug Delivery explores traditional drug delivery techniques as well as emerging advanced drug delivery techniques. By reviewing many types of polymeric drug delivery systems, and including key points, worked examples and homework problems, this book will serve as a guide to for specialists and non-

Memory Enhancement Strategies: What Works Best for Obtaining Memory Goals? -- Mental and Physical Exercise as a Means to Reverse Cognitive Aging and Enhance Well-Being -- Consumer-Based Brain Fitness Programs -- Synapse: A Clinical Trial Examining the Impact of Actively Engaging the Aging Mind -- Meditation, Mindfulness, Cognition, and Emotion: Implications for Community-Based Older Adult Programs -- Keys to a Sharp Mind: Providing Choice and Quality Programming in a Retirement Community -- Osher Lifelong Learning Institute at the University of Montana: A Model of Successful University and Community Partnerships -- Closing the Generation Gap: Using Discussion Groups to Benefit Older Adults and College Students -- A Practical Guide to Senior Odyssey -- Spelling Clubs and Competitions for Older Adults: Language Boosting Within a Social Context -- Oral Life Review in Older Adults: Principles for the Social Service Professional -- Creative Writing Groups: A Promising Avenue for Enhancing Working Memory and Emotional Well-Being -- Peer-Led Memory Training Programs to Support Brain Fitness -- Cognitive Wellness for Diverse Populations -- The Role of Physical Activity in Cognitive Fitness: A General Guide for Community Programs -- Nutrition and Nutritional Supplements to Promote Brain Health -- Enhancing Healthy Cognitive Aging Through Theater Arts -- Coming Alive: Kairos Dance Theatre's Dancing Heart[TM] - Vital Elders Moving in Community -- Art, Museums, and Culture -- The Songwriting Works[TM] Model: Enhancing Brain Health and Fitness Through Collaborative Musical Composition and Performance -- Supporting Cognition and Well-Being in Older Adults with Mild Cognitive Impairment: A Pilot Intervention -- Early Memory Loss Clubs: A Novel Approach for Stimulating and Sustaining Cognitive Function -- Implementing the "I'm Still Here"[TM] Approach: Montessori-Based Methods for Engaging Persons with Dementia -- Kirtan Kriya Meditation: A Promising Technique for Enhancing Cognition in Memory-Impaired Older Adults -- Brain Brightening: Neurotherapy for Enhancing Cognition in the Elderly -- Neurons in Neighborhoods: How Purposeful Participation in a Community-based Intergenerational Program Enhanced Quality of Life for Persons Living with Dementia -- Experience Corps®: A Civic Engagement-Based Public Health Intervention in the Public Schools.

Rationale for developmental interventions in children -- Enhancing childhood development in a normal child -- Enhancing childhood development in children with autism -- Enhancing childhood development in children with cerebral palsy and other disorders -- Enhancing childhood development in children with behavioral and psychological disorders -- Nutrition for better development -- Summary of the "Care for Childhood Development" program (UNICEF/WHO).

Enhancing Medication Adherence: The Public Health Dilemma is a comprehensive guide to medication adherence for the healthcare professional. Clinicians and pharmacists alike can benefit from key opinion leader and author Hayden Bosworth's text as he explains the details and causes behind medication nonadherence as well as methods on how healthcare providers can determine if a patient is nonadherent. Additionally, Bosworth discusses various studies, which assess adherence, adherence-related technology, best practices for clinicians and pharmacists, and future directions and recommendations in the field.

Introduction to the guidelines. Purpose, target and scope -- Background -- A dual obligation, a quadruple imperative -- Indispensability of controlled medicines in contemporary medical practices -- Safety of controlled medicines -- Current availability -- Impediments to availability, accessibility and affordability -- Why and how to work with this document? -- Guidelines for ensuring balance in national policies on controlled substances. Content of drug control legislation and policy -- Authorities and their role in the system -- Policy planning for availability and accessibility -- Healthcare professionals -- Estimates and statistics -- Procurement -- Other -- Country assessment checklist.

"Children with disabilities and complex medical and educational needs present a special challenge for policy makers and practitioners. These children exhibit tremendous heterogeneity in their conditions and needs, requiring a varied array of services to meet those needs. Uneven public and professional awareness of their conditions and a research base marked by significant gaps have led to programs, practices, and policies that are inconsistent in quality and coverage. Parents often have to navigate and coordinate, largely on their own, a variety of social, medical, and educational support services, adding to the already daunting financial, logistical, and emotional challenges of raising children with special needs. The unmet needs of children with disabilities and complex medical and educational needs can cause great suffering for these children and for those who love and care for them. To examine how systems can be configured to meet the needs of children and families as they struggle with disabilities and complex health and educational needs, the National Academies of Sciences, Engineering, and Medicine held a workshop in December 2015. The goal of the workshop was to highlight the main barriers and promising solutions for improving care and outcome of children with complex medical and educational needs. Workshop participants examined prevention, care, service coordination, and other topics relevant to children with disabilities and complex health and educational needs, along with their families and caregivers. More broadly, the workshop seeks actionable understanding on key research questions for enhancing the evidence base; promoting and sustaining the quality, accessibility, and use of relevant programs and services; and informing relevant policy development and implementation. By engaging in dialogue to connect the prevention, treatment, and implementation sciences with settings where children are seen and cared for, the forum seeks to improve the lives of children by improving the systems that affect those children and their families. This publications summarizes the presentations and discussions from the workshop"--Publisher's description.

ENT Board Prep is a high-yield review that is an ideal study guide for the ENT in-service and board exams. While other review guides are low yield or more of a textbook, this is quick, concise, and easy-to-use, providing everything you need to know in a easy to digest format. ENT Board Prep offers review on sections such as cancer, ear, sinus, plastics, sleep, and laryngology, as well as case studies useful for studying for the oral board exams. Written and edited by leaders in the field, this book aims to serve future residents and fellows in those crucial weeks leading up to the ENT board exam.

Enterobacter sakazakii and Salmonella are the primary pathogens of concern with regard to powdered infant formula. Guidance for the control of these hazards is currently being developed by Codex Alimentarius through the revision of the Recommended International Code of Hygienic Practices for Foods for Infants and Children. FAO and WHO are providing the scientific advice to facilitate this work. FAO and WHO implemented the first meeting on this issue in 2004, the outcome of which is reported in number six of this series. This report builds on the information and advice provided in 2004.

This report provides a review of commented Entrobacter sakazakii (Cronobacter spp.) infections worldwide in infants and young children as well as the existing surveillance systems and their capacity to capture cases of E. sakazakii (Cronobacter spp.) infection.--Publisher's description.

This thesis examines three topics that are related to the Gram-positive bacterial cell envelope. First, I examine how transmembrane proteins navigate through the thick, heavily cross-linked Gram-positive cell wall while remaining anchored to the bacterial membrane. I develop a theoretical model that predicts that entropic confinement of a disordered protein can drive translocation through the cell wall. I experimentally test important predictions of the model to demonstrate that translocation depends on the length of the translocating protein and the geometry of the bacterial surface, while demonstrating that entropy-driven translocation occurs in a variety of Gram-positive species. Second, I study how the antimicrobial peptide nisin causes cell death in Gram-positive bacteria. I demonstrate that nisin treatment triggers membrane collapse in multiple Gram-positive species, and provide evidence that collapse is initiated by an increase in compressive stress in the membrane. Finally, I examine the process of cell division in the Gram-positive coccus Staphylococcus aureus. Contrary to the current view of S. aureus division, cell volume increases monotonically during the cell cycle, as opposed to occurring entirely during cell separation. I observed a dramatic millisecond hemisphere-to-sphere transition during cell separation that was accompanied by a decrease in surface area, suggesting that separation is associated with a redistribution of cell wall stress.

"Enumerating Invisibility, Humanizing Numbers: Public Health and the Production of Inequities 1938-1974" is directed at answering one question: Why in spite of intensive study that has resulted in a wealth of numerical and statistical information on public health does the San Joaquin Valley and the residents therein remain, among one of the most underfunded, overlooked, impoverished and unhealthy regions? Through an examination of historical materials-- surveys, reports, occupational surveillance, and decision making-- this dissertation seeks to better understand how data and policy, through the social processes of classification and quantification, may have contributed to the production of inequities in the San Joaquin Valley. There are few studies to date that systematically examine the relationship between knowledge and numbers and even fewer that address the concerns of frequently overlooked communities of agricultural laborers in the San Joaquin Valley. This dissertation begins to fill these gaps by reviewing a diverse array of source material to trace how institutions counted and measured agricultural laborers, how the institutions shaped these counting practices, and how numbers shaped policies. Given that institutional identities and strategies of governance are at stake in the production of these numbers, the story of agricultural laborers their health, social, and scientific visibility must be told alongside the stories of state bureaucracies. In tracing how institutions counted and measured agricultural laborers, how the institutions shaped these counting practices, how numbers shaped policies and decisions, there is an opportunity to understand historically the potential consequences of these counting practices. Together they reveal how institutional identities contributed to the making of public health data-- its production, content and interpretation. This data, meant to reveal patterns of disease and improve public health, has paradoxically played a role in concentrating health inequities in the San Joaquin Valley because it has often made invisible the relationships between material deprivation and health or the environment and health. This dissertation does not advocate that we cease to use numbers in science and in policy. Rather, it is meant to recognize that every system of data collection and surveillance, regardless of the institution producing the data, is subjective and is shaped by particular values that have material consequences on populations As a result, the analysis intends to render numbers and their production more transparent and therefore open to critical analysis, and to provoke reflection on how the human elements- history, culture, and experiences --can explain the inequities that data alone can conceal.

The impairment of lung function caused by environmental exposure to pollutants and toxicants is a rising health problem, particularly in highly industrialized parts of the world. The problem is urgently calling for the development of new methodologies to assess both the level of elemental exposure and the effects for quality of health and longevity. This volume provides state-of-the-art information about the recent advances in occupational and non-occupational pollutant-related disorders of the respiratory tract, and the assessment of a threat they pose for the health-span. Heavy traffic-related air pollution, unnoticeable but salient health detriment, is dealt with at length.

The book presents the latest advances in research into health effects of air pollution, with heavy motor vehicle traffic or cigarette smoke as the exemplar of pollution. The airways are the first-line defense system against pollution. The book focuses on respiratory ailments underlain by inflammation, increased susceptibility to infection, particularly acquired during harsh environmental conditions and exposures to particulate matter or pathogens. The importance of astute analysis of lung function for early diagnosis of disorders is underscored. A knowledge deficit concerning the aerosolized drug delivery through the airways also is addressed. Recent developments and viewpoints in the field of environmental health hazards as well as methodological advances in their assessment are provided. The book will be of interest to pulmonologists, healthcare providers, researchers and clinicians engaged in environment-related respiratory diseases, but also to policy makers concerned with clean ambient air quality.

The capacity of the epigenome to interpret both internal and external stimuli and alter expression programs is a critical component in normal development, aging, and disease pathogenesis. In the past decade, we have witnessed an explosion of unprecedented research on and support for epigenetics, epigenomics, and their interface with human health and disease. In this volume, Environmental Epigenomics in Health and Disease - Epigenetics and Complex Diseases, a number of leading investigators in the field of epigenetics discuss patterns of epigenomic modifications in normal cells, and how environmentally-induced changes in them are associated with disease pathogenesis. The authors comprehensively review the epigenetic adaptations that occur in human embryonic stem cells, as well as in differentiating cells and organs such as the brain when exposed to environmental factors, and discuss the legal and ethical implications of such alterations. The overall purpose of this volume and its companion, Environmental Epigenomics in Health and Disease - Epigenetics and Disease Origins, is to give readers an overview of how environmental exposures during early development can influence disease formation by disrupting epigenetic programming.

Exposure to environmental toxicants is associated with changes in DNA methylation and gene expression profiles that together can contribute to increased disease susceptibility. The chapters in this volume, Environmental Epigenomics in Health and Disease - Epigenetics and Disease Origins, address a wide range of environmental exposures, such as airborne particulates, cocaine, radiation, tobacco smoke, and xenoestrogens. Particular emphasis is placed on the consequences of environmental exposures during development on epigenetic reprogramming that influences adult disease pathogenesis. Health outcomes associated with these exposures include autoimmune disorders, neurodevelopmental disorders, and cancer. Importantly, dietary supplements and drugs can modify the epigenetic effects induced by these agents, thereby reducing their toxicological impact. The overall purpose of this volume and its companion, Environmental Epigenomics in Health and Disease - Epigenetics and Complex Diseases, is to give readers an overview of how environmental exposures during early development can influence disease formation by disrupting epigenetic processes and developmental programming.

"Satellite imagery and data are widely used in public health surveillance to provide early warning of disease outbreaks and for averting pandemics. Convergence of these technologies began in the 1970s and has gained wide acceptance in the 21st Century. This book is written jointly by experts in both the health and Earth-science technologies. Each chapter is accompanied by an extensive list of citations to provide background and validation of the current state-of-the-art for a variety of high-interest human diseases and associated health and well-being issues. The importance of day-to-day weather patterns, the impacts of severe weather events and longer-term climate cycles form the basis for developing information systems that meet goals and expectations of national and international health monitoring bodies"--Provided by publisher.

Common diseases arise out of combination of both genetic and environmental influences. Advances in genomic technology have enabled investigators to create hypotheses regarding the contribution of genetic factors at a breathtaking pace. However, the assessment of multiple and specific environmental factors--and their interactions with the genome-- has not. We lack high-throughput analytic methodologies to comprehensively and systematically associate multiple physical and specific environmental factors, or the "envirome", to disease and human health. We claim that the creation of hypotheses regarding the environmental contribution to disease is practicable through high-throughput analytic methods that have been well established in genomics. In the following dissertation, we develop and apply methods to systematically and comprehensively associate specific factors of the envirome with disease states, prioritizing factors for in-depth future study. The current disciplines of studying the environmental determinants of health include toxicology and epidemiology, which operate on molecular and population scales, respectively. This dissertation proposes approaches in both of these disciplines. For example, we have developed a framework to conduct the first "Environment-wide Association Study" (EWAS), systematically associating environmental factors to disease on a population scale. We have applied this framework to investigate type 2 diabetes and heart disease on cohorts that are representative United States population, finding novel and robust associations in diverse and independent cohorts. Given the lack of explained risk resulting from current day genome-wide studies, the time is ripe to usher in a more comprehensive study of the environment, or "enviromics", toward better understanding of multifactorial diseases and their prevention.

Enzinger and Weiss's Soft Tissue Tumors is a medical reference on the diagnosis of tumors of the skeletal muscles, connective tissue, fat, and related structures. Microscopic findings are correlated with the latest developments in molecular biology, cytogenetics, and immunohistochemistry, providing you with a comprehensive and integrated approach to the evaluation of soft tissue specimens. Apply the latest advances in surgical pathology thanks to major updates on recently identified pathological entities such as soft tissue angiofibroma and CIC-related sarcomas; coverage of the newest molecular diagnostic techniques and immunohistochemical and molecular genetic features of soft tissue tumors; new chapters on GIST and soft tissue tumors showing melanocytic differentiation; and more. Effortlessly find the information you need with a chapter organization based on the newest surgical pathology concepts and classifications of soft tissue tumors.

Transformations using enzymes have been extensively investigated in the last two decades and the results promise great potential for this growing field, especially in the area of synthetic organic chemistry mainly due to of its many advantages. Accordingly, this book has attempted to bring out the advantages of using enzymes involving complex underivatized and unprotected substrates in non-polar media under homogenous and heterogeneous reaction conditions. Merits and demerits of using enzymes in terms of yields and selectivity/specificity are presented without any prejudice. Almost all the reactions dealt with are from the author's laboratory comprising diverse substrates, and the catalysis involves two important hydrolyzing enzymes, extensively examined for the reverse reactions. Thus, esterification involving lipses and glycosylation involving glycosidases were investigated with respect to various strategies like optimization of reaction conditions, response surface methodology and kinetics, carrying out reactions under solvent, non-solvent and super critical carbon dioxide conditions. In short, the work presented is to ensure the comprehension of the problems faced by the researchers in this area so as to work out further efficient strategies for carrying out enzymatic transformations in the laboratory successfully with better yields and specificity.

"'Do no harm' a particularly leading and important phrase in the delivery of healthcare is not working. In fact depending on the epidemiological approach and which data sets one applies, medical errors, hospital acquired infections (HAIs) and pharmaceutical errors combined are the second or third leading killer of Americans annually: approximately 300,000 die from a combination of medical errors, hospital acquired infections (HAIs), and pharmaceutical errors...100,000 per category. Add to these numbers the hundreds of thousands who are harmed (morbidity) but not killed (mortality) changing quality of life and a substantial problem is defined"--Provided by publisher.

The plague era - Modernity: new concepts of the state and the body -- Cholera: the return of epidemic disease and the abandonment of traditional protective measures -- The "English System:" new methods gain acceptance -- The sanitary reform movement: from miasma theory to departments of health -- Vaccination: a powerful paradigm -- The era of spectacular victories -- The end of a dream?

Epidemiology, by award-winning educator and epidemiologist Leon Gordis, is a best-selling introduction to this complex science. Dr. Gordis leverages his vast experience teaching this subject in the classroom to introduce the basic principles and concepts of epidemiology in a clear, uniquely memorable way. He guides you from an explanation of the epidemiologic approach to disease and intervention, through the use of epidemiologic principles to identify the causes of disease, to a discussion of how epidemiology should be used to improve evaluation and public policy. It's your best choice for an accessible yet rich understanding of epidemiology! Gain a solid foundation of basic epidemiologic principles as well as practical applications in public health and clinical practice.Visualize concepts vividly through abundant full-color figures, graphs, and charts.Check your understanding of essential information with 320 multiple-choice epidemiology self-assessment questions (120 inside the book plus 200 more online).Access the complete contents online at Student Consult, including over 200 additional multiple-choice epidemiology self-assessment questions not found in the book, with answers to all questions as well as full rationales explaining why every answer is correct or incorrect.

The average age of the world's population is increasing at an unprecedented rate and this increase is changing the world. This 'silver tsunami' emphasizes the need to provide advanced training in epidemiology and increase the cadre of experts in the study of aging. This book is designed to summarize unique methodological issues relevant to the study of aging, biomarkers of aging and the biology/physiology of aging and in-depth discussions of the etiology and epidemiology of common geriatric syndromes and diseases. Contributing authors in the book represent many disciplines, not only epidemiology and clinical geriatrics, but also demography, health services, research, cardiovascular disease, diabetes, psychiatry, neurology, social services, musculoskeletal diseases and cancer. The aim of the book is to provide a broad multidisciplinary background for any student/researcher interested in aging. The material in the book is organized and comprehensive. It represents the most up-to-date information on the scientific issues in aging research written by academics who specialize in research and training in the broad field of aging.The structure and organization of the book reflects our course series in the Epidemiology of Aging starting with the broad issues of demography and methodology, and then addressing specific health conditions and geriatric conditions common to older persons.

Authored by Bengt Kallen, professor emeritus in embryology at Lund University in Sweden. The subject of this book is to describe the occurrence of congenital malformations among children born and what risk factors exist. Population data are presented for a number of malformations, ascertained with the use of data from the Swedish national health registers for the period 1998-2010 corresponding to some 1.3 million births, together with prospectively collected information on a group of exposures of possible interest.

pt. I. -- 1. The Doctrine of contagion -- 2. Modern theories, analysis of -- 3. The Propagation of cholera -- 4. Epizootics, or, Disease in the brute creation -- pt. II. Will shortly be issued, and will embrance the following subjects -- 5. The Remote cause of epidemic diseases in the animal creation -- 6. The Cause of blight and pestilence in the vegetable creation -- 7. The Cause of hurricanes, and abnormal atmospherical vicissitudes -- 8. Historical pathology, or a Brief history of the pestilences, murrains and blights, with the aberrations in the material world that have been observed during historical periods.

This book offers an in-depth examination of labor pain and analgesia with the aim of promoting natural childbirth without pain. All aspects of the subject are covered, including the latest techniques of delivering labor analgesia. Importantly, emphasis is placed on a holistic approach, detailed attention being paid to the humanization of childbirth and behavioral aspects in addition to evidence-based medicine. Potential future developments are also addressed, with discussion of opportunities that have yet to be realized. In order to ensure that the text is easily readable for trainees as well as established practitioners, chapters have been restricted to a manageable length and information is presented clearly and succinctly. Step-by-step tutorials and boxes highlighting practical points are used to clarify technical aspects. The authors include both well-established experts and young emerging professionals from various European countries, ensuring an intercultural perspective.

Behavioral Epigenetics is the study of how environmental factors affect alterations in behavior, addressing the fundamental mechanisms that shape development and individual vulnerability/resilience to adverse behavioral outcome. With an understanding of the molecular mechanisms involved in epigenetic modulation, researchers believe it will be possible to develop targeted therapies for those individuals in whom it malfunctions. This volume will address current understanding of the roles of epigenetic processes at the molecular/cellular level, their impact on neural development and behavior.

The ability of an animal to change quickly in response to its surroundings is essential to its survival and in some species, individuals respond by changing phenotype. The studies in this thesis focus on the molecular mechanisms through which environmental information can affect changes in phenotype in an African cichlid fish, Astatotilapia burtoni. This species is particularly useful for this study, as adult male burtoni assume one of two distinct, reversible, behavioral and physiological phenotypes. Dominant (D) males are brightly colored, reproductively capable and engage in mating and aggressive territorial behaviors while non-dominant (ND) males are drably colored, reproductively incapable, and are behaviorally passive. Importantly, the transition from ND to D or the reverse can occur in a matter of minutes and is triggered solely by external social cues. How such external information is translated into phenotypic changes on the molecular level is the focus of these experiments and my data suggest an epigenetic mechanism may regulate this transition. The specific epigenetic mechanism assessed here is DNA methylation, which is the covalent attachment of a methyl group to the cytosine nucleotide of DNA, which can lead to changes in expression. First, I showed that DNA methylation is present in A. burtoni, as not all animals utilize this mechanism. I used immunohistochemistry to demonstrate that high levels of global methylation are present in the nuclei of all cells examined, most likely bound with the highest frequency to heterochromatin, to suppress transcription of specific transcribed regions. However, there were no differences detected between behavioral states using these methods. Next I demonstrated that epigenetic mechanisms play a role during the determination of social status by treating juvenile males with epigenetic modifiers that either promote or interfere with DNA methyltransferase (DNMT). Animals injected with zebularine, which blocks the activity of DNMT, were statistically unlikely to ascend to D status, while those injected with methionine, which acts as a methyl donor, were statistically likely to become D males. Once a potential role for DNA methylation in social status determination was found, I surveyed potential sites of action on the GnRH1 gene, a key regulator of reproductive behavior, for variations in methylation on the single nucleotide level. I found that fully established Ds and NDs do not have differences in methylation levels in any on the individual nucleotides assayed on the GnRH1 promoter or coding region; however, juvenile males have lower levels of methylation than Ds at some sites on the promoter, while males transitioning to D status have lower average promoter methylation, but higher average coding region methylation than D males. Furthermore, ND animals injected with zebularine have higher average levels of methylation on both the promoter and coding region than control ND males. In order to better understand the context of the methylation changes during sexual maturation, methylation levels on the GnRH1 gene were measured during normal development. GnRH1 methylation levels remain constant between two and four weeks of age but increase significantly at several sites between 4 and 6 weeks of age. Furthermore, crowding mothers during the brooding stage and raising young in crowded tanks results in lower methylation levels at both 2 and 6 weeks of age, as well as causing delayed growth at the 6 week stage. Finally, I measured GnRH1 methylation in a non-reproductive context. Since GnRH agonists can interfere with short-term memory in humans, I measured changes in methylation in the GnRH1 gene during memory formation and storage. Animals who successfully learned a memory task showed a correlation with higher methylation at sites in the GnRH1 coding region than non-learners. Learners were successfully able to recall their training after three months; however, the increased methylation in the coding region was no longer present. In summary, DNA methylation is present in A. burtoni and increases on the GnRH1 gene promoter and coding sequence during transitions in development and sexual maturation. As GnRH1 expression levels are known to increase in these cases, increased methylation is not acting canonically as a repressor of expression on GnRH1. During short-term learning, higher methylation is limited to only the coding region of GnRH1, indicating that there may be several different epigenetic regulatory pathways involving this gene. Furthermore, the observation that there are no differences in GnRH1 methylation between stable D and ND males, or, in the long-term, between learners and non-learners, suggests that methylation in this location may be transitory and used as a short-term marker for other regulatory mechanisms.

Previous observations, generated by many in the field, have provided a first glimpse into the epigenetic mechanisms that underpin lymphocyte and myeloid development. We are only now beginning to merge the multitude of observations into a common framework. At the same time it has become more difficult for the individual mind to comprehend more than a tiny focused fraction of it. The studies described in this volume serve as a starting point to familiarize one self with the multifarious differences in epigenetic designs that orchestrate the progression of developing blood cells. They also may serve as a general paradigm for the mechanisms that underpin the control of eukaryotic gene expression.

In both mammals and insects an olfactory neuron will usually select a single olfactory receptor and repress remaining members of large receptor families. Here we show that a conserved multiprotein complex Myb-MuvB(MMB)/dREAM plays an important role in mediating neuron-specific expression of the CO2 receptor genes (Gr63a/Gr21a) in Drosophila. Activity of Myb in the complex is required for expression of Gr63a/Gr21a and it acts in opposition to the histone methyltransferase Su(var)3-9. Consistent with this, we observe repressive di-methylated H3K9 modifications at the receptor gene loci suggesting a mechanism for silencing receptor gene expression. Conversely, other complex members, Mip120 and E2F2, are required for repression of Gr63a in inappropriate neurons. Misexpression in mutants is accompanied by an increase in the H3K4me3 mark of active chromatin at the receptor gene locus. Nuclei of CO2 receptor-expressing neurons contain reduced levels of the repressive subunit Mip120 compared to surrounding neurons and increased levels of Myb, suggesting that activity of the complex can be regulated in a cell-specific manner. Our evidence suggests a model in which olfactory receptors are regulated epigenetically and the MMB/dREAM complex plays a critical role in specifying, maintaining and modulating the receptor-to-neuron map.

The growing knowledge about disturbances of epigenetic gene regulation in hematopoietic stem cell disorders such as myeloid leukemias and preleukemias (myelodysplasias) is now being translated into treatment approaches that target the epigenetic defects pharmacologically. Such approaches include reactivation of tumor suppressor genes and other antiproliferative genes by reversal of DNA hypermethylation through azanucleosides, and use of HDAC inhibitors to reverse gene silencing mediated by chimeric, leukemia-specific transcription factors. This book first presents the latest evidence derived from preclinical models regarding the epigenetic regulation of hematopoietic stem cell differentiation and hemoglobin production. The significance of DNA methylation abnormalities in hematopoietic disorders and of epigenetic disturbances in lung cancer and other solid tumors is then discussed. A major part of the book, however, relates specifically to the translation of basic research and drug development to clinical applications, and in this context both present and future clinical strategies are considered. Individual chapters are devoted to the use of DNA hypomethylating agents and chromatin-modifying agents, and the treatment of hematologic malignancies and solid tumors by means of epigenetic agents is discussed in detail.

Epigenetics is the phenomenon which fine tunes the processes associated with life, beyond that which is specified by the sequence of the genetic material; DNA. The covalent modification of DNA, DNA associated histones, several non histone proteins as well as non coding RNA coherently operate to establish the epigenetic regulation of gene expression in physiological and pathophysiological conditions. This volume presents contributions from worldwide experts presenting their research and findings, including: the evolution of epigenetic machineries from archaea to higher eukaryotes; role of epigenetics in development and transcription regulation; epigenetic landscape of human disease; a chemical biology approach to understanding epigenetic phenomena; exploration of different small molecules as epigenetic therapies.This volume is aimed at students and researchers of chromatin biology and epigenetics and will also be of interest to a broader pharmaceutical audience.

"Epigenetics and Complex Traits provides an overview of basic epigenetic phenomena that influence transmission of genetic traits, including the pivotal roles of epigenetic factors in genome integrity, genetic transmission and phenotypic variation at critical developmental points, interactions between epigenetic marks and genetic variation, as well as a detailed examination of how epigenetic considerations can alter interpretation and analysis of risks for complex traits. Included in this book are several overviews of the impact of inter-individual variation in epigenetic states, from major changes that cause congenital developmental defects to subtle changes and their impact on complex traits. In addition, there are chapters examining the relationship between epigenetic changes and genetic changes in human disease, methods for statistical analysis of epigenetics effects in human disease genetic studies or in population genetics, and a consideration of how epigenetics influences inheritance and analysis of inheritance. Epigenetics and Complex Traits is a resource for those who are working in mammalian genetics or analysis of human genetic data and are interested in the impact of epigenetics on inheritance."-- Back cover.

"What lies at the heart of neuronal plasticity? Accumulating evidence points to epigenetics. This word originally indicated potentially heritable modifications in gene expression that do not involve changes in DNA sequence. Today this definition is much less strict, and epigenetic control is thought to include DNA methylation, histone modifications, histone variants, microRNA metabolic pathways and non-histone proteins modifications. Thus, while neuronal plasticity is rightly thought to be intimately associated to genomic control, it is critical to appreciate that there is much more to the genome than DNA sequence. Recent years have seen spectacular advances in the field of epigenetics. These have attracted the interest of researchers in many fields and evidence connecting epigenetic regulation to brain functions has been accumulating. Neurons daily convert a variety of external stimuli into rapid or long-lasting changes in gene expression. A variety of studies have centered on the molecular mechanisms implicated in epigenetic control and how these may operate in concert. It will be critical to unravel how specificity is achieved. Importantly, specific modifications seem to mediate both developmental processes and adult brain functions, such as synaptic plasticity and memory. Many aspects of the research in neurosciences and endocrinology during the upcoming decade will be dominated by the deciphering of epigenetic control. This book constitutes a compendium of the most updated views in the field"--Publisher.

"Although epilepsy is one of the nation's most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living. The Institute of Medicine was asked to examine the public health dimensions of the epilepsies, focusing on public health surveillance and data collection; population and public health research; health policy, health care, and human services; and education for people with the disorder and their families, health care providers, and the public. In Epilepsy Across the Spectrum, the IOM makes recommendations ranging from the expansion of collaborative epilepsy surveillance efforts, to the coordination of public awareness efforts, to the engagement of people with epilepsy and their families in education, dissemination, and advocacy for improved care and services. Taking action across multiple dimensions will improve the lives of people with epilepsy and their families. The realistic, feasible, and action-oriented recommendations in this report can help enable short- and long-term improvements for people with epilepsy. For all epilepsy organizations and advocates, local, state, and federal agencies, researchers, health care professionals, people with epilepsy, as well as the public, Epilepsy Across the Spectrum is an essential resource"--Publisher's description.

Written by expert epilepsy clinicians from the Mayo Clinic, Epilepsy Case Studies: Pearls for Patient Care presents a wide variety of case histories drawn from real life experiences in people with seizures. Designed to stimulate the same deductive reasoning that is commonly used when seeing epilepsy patients in the clinic, this practical book presents the clinical scenario and then poses a range of stimulating questions to organize the reader's thoughts to address each case. Questions that revolve around each case include common ones such as "How does this test help us with the diagnosis" and "What is the precise relationship of the patient's seizures to their overall neurological condition". The most poignant questions include "How does this information help us to devise a treatment plan?" and "What do we know about the anticipated course and prognosis?" The questions raised in each section incorporate the clinical course and evaluation. Where possible, the discussion relies upon the latest medical evidence to support the responses and includes up-to-date techniques used for patients with and without seizure control. At the end of each case a few salient citations are referenced, as are a few of the more pertinent articles that the reader can reference to obtain an overview of the topic.

Epilepsy, Part I, Basic Principles and Diagnosis, Volume 107, in the Handbook of Clinical Neurology series offers a comprehensive review of our knowledge of the field today, including epidemiology, basic mechanisms, animal models, and topics of increasing interest such as the role of inflammation in epilepsy. It provides a comprehensive approach to description of the clinical, electrographic and imaging aspects of the epilepsies, with a clear outline of contemporary classification and the role of modern diagnostic techniques, as well as neuropsychological and psychiatric aspects of epilepsy. Chapters are authored by internationally respected neurologists with varied perspectives insuring depth to the content. A volume in the Handbook of Clinical Neurology series, which has an unparalleled reputation as the world's most comprehensive source of information in neurology. International list of contributors including the leading workers in the field. Describes the advances which have occurred in clinical neurology and the neurosciences, their impact on the understanding of neurological disorders and on patient care.

Epilepsy, Part II, Treatment, Volume 108, provides a full description of epilepsy pathology and etiology, antiepileptic drug treatment, the approach to surgical evaluation and alternative procedures to be considered, in both children and adults, as well as brain stimulation and diet treatment. Economic and psychosocial issues such as stigma are fully covered. The special problems of epilepsy treatment in the developing world are described. Chapters are authored by internationally respected neurologists with varied perspectives insuring depth to the content. Epilepsy, Part I, Basic Principles and Diagnosis, Volume 107, establishes the scientific and practical diagnosis of epilepsy. The volumes will be a very important resource for basic scientists, clinical investigators, and all health professionals treating patients with epilepsy. *A volume in the Handbook of Clinical Neurology series, which has an unparalleled reputation as the world's most comprehensive source of information in neurology. *International list of contributors including the leading workers in the field. *Describes the advances which have occurred in clinical neurology and the neurosciences, their impact on the understanding of neurological disorders and on patient care.

"Integrating the studies of epilepsy, neurosciences, computational neurosciences, mathematics, physics, engineering, and medicine, this volume provides the first means to a clear, structured, and enriching multidisciplinary perspective for developing students, researchers, and clinicians in the field of epilepsy. The text gives up to date information on the state of current research, possible future research, and clinical directions in the fields of epilepsy and seizure dynamics. Clear illustrations that illustrate the patterns of brain electrophysiology and behavioral manifestations are provided to aid comprehension. The authors include extensive references in each chapter to enhance further study"--Provided by publisher.

How shall we improve human health? One answer is: by eradication. The Gates Foundation announced in 2007 that their goal is malaria eradication; another of their priorities is polio eradication. Eradication means the complete elimination of a disease through deliberate human intervention. It stands for an absolute in public health. This book by the award-winning historian of medicine Nancy Leys Stepan is an accessible, beautifully written, and deeply researched examination of one of the most controversial issues in public health today. The eradication of disease might seem like an absolute good. But critics of eradication argue that the huge resources needed to achieve eradication could be better allocated toward developing primary health services and general improvement in health. This book aims to look at the benefits and drawbacks of single-minded efforts to rid the world of particular diseases, one at a time. The sweep of the book is impressive, from the origins of the idea of complete eradication in the early twentieth century until the present-day campaigns against polio, Guinea worm disease, and now malaria. The author places eradication's story in its many contexts, from imperialism, changing notions of public health, the history of medicine and its technologies, the development of international health agencies such as the World Health Organization, and the impact of the Cold War on the shift of attention to disease in developing countries. -- Jacket.

This volume provides a comprehensive review of ERCP and EUS and the clinical conditions for which they are employed. Presented in a case-based format with accompanying videos, it will serve as a valuable practical clinical resource for gastroenterologists with an interest in ERCP and EUS. The text highlights major techniques involved in ERCP, reviews complications and recent data on preventing post-ERCP pancreatitis, and discusses important issues in ERCP training. The EUS chapters review the breadth of equipment available for performing EUS and EUS-FNA, detail the technique of performing EUS-FNA, and explore pertinent issues with training and assessing competency analogous to ERCP training. Valuable insights on the basics of cytopathology relevant to the endosonographer are summarized. The classic indication for EUS of staging luminal cancers is also examined in detail, while pancreaticobiliary indications are discussed highlighting newer adjunctive technologies including elastography and contrast-enhanced EUS. ERCP and EUS: A Case-Based Approach will serve as a very useful resource for physicians who perform or refer patients for ERCP and EUS. It provides a concise yet comprehensive summary of the current status of ERCP and EUS that will help guide patient management and stimulate clinical research. Supplementary video files are available for this book and can be accessed at http://link.springer.com/book/10.1007/978-1-4939-2319-9.

This concise guide to the often overlooked association between erectile dysfunction and hypertension/cardiovascular disease covers a wide range of aspects of importance to the clinician. It examines the impact of antihypertensive drug therapy on erectile function and explains how the management of erectile dysfunction in hypertensive patients depends on a variety of factors. Different treatment approaches are described, including lifestyle modification, PDE-5 inhibitors and other novel agents, and behavioral therapy, and helpful therapeutic algorithms are presented. A further focus of the book is the potential role of erectile dysfunction as an early diagnostic indicator of asymptomatic coronary artery disease and a prognostic marker for cardiovascular events. In addition, key background information is supplied on epidemiology and pathophysiology, and the significance of erectile dysfunction in different patient groups, such as the elderly and those with chronic kidney disease, is examined. Erectile dysfunction is a major public health problem affecting more than ten percent of the general male population and is now considered to be predominantly of vascular origin. This book will be informative and of practical value for all practitioners responsible for caring for the very many patients who experience erectile dysfunction in the setting of hypertension and cardiovascular disease.

Esophageal cancer causes an estimated 386,000 deaths worldwide and is the sixth most common cause of death for men. The background characteristics of esophageal cancer treatment are markedly different between Asian and Western countries, however. In tumor histology, squamous cell carcinoma associated with smoking and alcohol consumption is overwhelmingly prevalent in Asia, whereas adenocarcinoma associated with Barrett?s metaplasia is markedly prevalent in the West. In Asia, especially in Japan, the key persons who play important roles in the management of esophageal cancer patients are surgeons; in the West those roles are filled by medical and radiation oncologists as well as surgeons. The philosophy of surgeons regarding cancer surgery varies from locoregional to local tumor control, particularly in focusing on lymph node dissection. Physicians? approach to surgical adjuvant therapy differs, therefore, between Asia and the West. Considering these East?West differences in esophageal cancer treatment, the currently available results of Western evidence should not be considered directly applicable to esophageal cancer in Asia. In this book, the authors discuss the knowledge base in Japan in terms of treatment of esophageal squamous cell carcinoma. Since this volume contains a wide spectrum of current information and addresses topics surrounding the treatment of patients with esophageal squamous cell carcinoma, it is highly relevant to Asian physicians and researchers as well as to their counterparts in the West.

Drs. Fleisher and Roizen present a completely revised new edition that includes coverage of many new conditions, procedures, and drugs. This book makes it easy to formulate anesthesia plans through a consistent format and discussions of the problems, causes, comorbidities, and anesthesia implications for over 600 clinical topics. Quickly reference key information using the carefully templated text that highlights the most important anesthetic considerations in a consistent, user-friendly layout. Stay current on the latest anesthetic implications in regards to coexisting diseases, procedures, drugs, and alternative and complementary therapies, including coverage of mitochondrial myopathy, atrial fibrillation ablation, awake craniotomy, stereotactic neurosurgery, neuroprotection, dexmedetomidine, and other hot topics. Master the core knowledge of Anesthesia and overcome new factors in anesthetic care of patients with trusted reference in a high yield format.

This book is a step-by-step manual for the complete echo-novice. The text focuses on the practicalities of performing an examination, and the interpretation of images. Avoiding unnecessary technicalities, it places particular emphasis on the diagnostic features of sample cases and covers the entire breadth of adult cardiology. The majority of the echo images are also available in a dynamic form on the Expert Consult platform. Also included is access to 100 case scenarios and images for self-assessment interpretation. Trainees in cardiology, echocardiography/cardiac physiology, anaesthetics, intensive care, general medicine, acute medicine, accident and emergency and cardiothoracic surgery.

Diagnosis and classification of mood disorders -- Natural course of mood disorders and its treatment -- History of lithium treatment -- Pharmacology and mechanisms of action -- Maintenance treatment with lithium -- Treatment of mania with lithium -- Treatment of depression with lithium -- Suicide prevention with lithium -- Other clinical indications of lithium including neuroprotective effects and its potential indications -- Lithium in pregnancy and postpartum period -- Practical management of lithium -- Adverse effects and its management -- Other treatments for bipolar disorder and major depression.

This concise, easy-to-follow text gives an insight into core techniques and practices in biomedical research and how, when and why a technique should be used and presented in the literature. Readers are alerted to common failures and misinterpretations that may evade peer review and are equipped with the judgment necessary to be properly critical of the findings claimed by research articles. --from publisher description

This book offers an excellent review of the various rheumatological conditions, both common and uncommon, that may present on imaging on a daily basis. The book uses a unique format that will be beneficial for clinicians, radiologists, medical students, and consultant staff. The text is written by both rheumatology and radiology staff to provide a balanced approach. A clinical overview and the common clinical presentations are briefly reviewed for each condition followed by a more detailed discussion of imaging findings produced by the various imaging modalities, including radiographs, ultrasound, MRI, CT, and nuclear medicine. This book details the imaging of normal musculoskeletal anatomy and pathology; discusses image-guided musculoskeletal interventions; and examines disorders such as rheumatoid arthritis, connective tissue disease, osteoarthritis, osteonecrosis, infection-related arthritis, soft tissue calcification, and bone and synovial tumors. Featuring over 600 multi-part, high-resolution images of rheumatic diseases across current imaging modalities, Essential Imaging in Rheumatology offers up-to-date and complete information on the imaging of these disorders.

This title is directed primarily towards health care professionals outside of the United States. This book has been prepared by professionals working in the UK. It covers the basic principles and practice of interventional cardiology, vascular and non-vascular, written specifically for the general cardiologist. Designed to facilitate easy access to key information, it contains numerous line illustrations, diagrams, graphs, and charts. The entire spectrum of interventional cardiology is covered in an easy-to-read format. In this new edition are fifteen new chapters written by experts from around the world. The excellent appendix of trials in interventional cardiology has been fully updated making this the best available source on how to apply trials to clinical practice. Includes editors and contributors from the US and Europe for a truly international perspective. Begins each chapter with 6-10 key points written in bullet format that summarize important concepts in the chapter, making reference a snap.

Neuromodulation is an emerging field that explores the use of electrical, chemical, and mechanical interventions to heal neurological deficits. Such neurostimulation has already shown great promise with disorders and diseases such as chronic pain, epilepsy, and Parkinson's disease. This is the first concise reference covering all of the basic principles of neuromodulation in a single affordable volume for neuro-residents, fellows, and basic clinical practitioners, edited by two prominent clinical experts in the field. This volume emphasizes essential observations from all of the important clinical phases involved in any neuromodulation: targeting, intraoperative assessment, programming, complications, and complication avoidance. There are commonalities to all neuromodulation procedures that must be brought to the forefront to form a cohesive presentation of neuromodulation, and such emphasis will give readers a more solid grounding in the fundamentals needed to embrace this field as a cohesive clinical entity.

Introduction -- Essential oil composition -- Toxicity -- Kinetics and dosing -- The skin -- The respiratory system -- The cardiovascular system -- The urinary system -- The digestive system -- The nervous system -- The reproductive system -- Cancer and the immune system -- Essential oil profiles -- Constituent profiles -- General safety guidelines.

Noted authority Mark D. Miller, MD, together with a stellar editorial team and numerous contributors representing a breadth of specialty areas within orthopaedics and primary care, offers you the comprehensive, multidisciplinary insight you need to confidently diagnose and treat sprains, fractures, arthritis and bursitis pain, and other musculoskeletal problems, or refer them when appropriate. Videos on DVD demonstrate how to perform 29 joint injections, 7 common physical examinations, a variety of tests, and 6 splinting and casting procedures. Presents multidisciplinary coverage that provides authoritative orthopaedic guidance oriented towards the practical realities of primary care practice.

The basic science important to nuclear imaging, including the nature and production of radioactivity, internal dosimetry and radiation detection and measurement, are presented clearly and concisely. Current concepts in the fields of radiation biology and radiation protection relevant to medical imaging, and a number of helpful appendices complete this comprehensive textbook. The text is enhanced by numerous full color charts, tables, images and superb illustrations that reinforce central concepts. The book is ideal for medical imaging professionals, and teachers and students in medical physics and biomedical engineering. Radiology residents will find this text especially useful in bolstering their understanding of imaging physics and related topics prior to board exams."--pub. desc.

Introduction to radiology -- The circulatory system: the heart and great vessels -- The respiratory system -- The digestive system -- The urinary tract -- The acute abdomen -- The reproductive system -- The musculoskeletal system -- Neuroimaging -- Pediatric radiology.

Oncogene addiction is thought to occur cell autonomously. Immune effectors are implicated in the initiation and restraint of tumorigenesis, but their role in oncogene inactivation-mediated tumor regression is unclear. Here, we show that an intact immune system, specifically CD4+ T cells, is required for the induction of cellular senescence, shutdown of angiogenesis, and chemokine expression resulting in sustained tumor regression upon inactivation of the MYC or BCR-ABL oncogenes in mouse models of T cell acute lymphoblastic lymphoma and pro-B cell leukemia, respectively. Moreover, immune effectors knocked out for thrombospondins failed to induce sustained tumor regression. Hence, CD4+ T cells are required for the remodeling of the tumor microenvironment through the expression of chemokines, such as thrombospondins, in order to elicit oncogene addiction.

This text presents a detailed introduction to SQLAlchemy, the code library for Python users that makes it easier to access popular databases such as Oracle and MySQL. It demonstrates how to use the library to create simple database applications, and walks readers through simple queries.

This practical, concise guide discusses how to distinguish different types of tremor and make the diagnosis of essential tremor.℗ℓ Written in an easy-to-read format, this book summarises other conditions that may be confused with essential tremor and details all current treatment options for this condition, including medications, surgery and non-invasive alternatives. Examination techniques for patients with a tremor complaint are described, some of which may be novel to the general practitioner, and case studies full of diagnostic and examination pearls are provided.℗ℓ℗ℓ℗ℓ Essential Tremor in Clinical Practice is an updated version of Abdul Qayyum Ranaℓ́ℓs previous book, An Introduction to Essential Tremor. Busy clinicians, including internists, general and family practitioners, and geriatricians will benefit from this short yet comprehensive, clinically focussed volume.

Extensively revised and updated, the second edition of Essential Urology: A Guide to Clinical Practice provides support to primary care physicians through its review of common genitourinary problems. This edition continues to provide the primary care physician with tools to better recognize urological diseases as well as updated management strategies for these disorders. To enhance the theme of comprehensive care and family medicine, the volume is formatted according to the life cycle and the urological challenges, which may be detected and diagnosed by primary care physicians respective of the patient's stage in life, beginning with pregnancy and in utero diagnoses. Pediatric themes such as infection and voiding dysfunctions are followed by adult urological topics ranging from prostate diseases, nephrolithiasis, overactive bladder syndromes, incontinence and urological cancer screening. Three new chapters are added addressing male infertility/andrology and the growing demand for integrative and alternative medical care of urologic patients, as well as commonly encountered dermatological problems in the genital area.Essential Urology: A Guide to Clinical Practice, Second Edition is extremely comprehensive and yet, very accessible. It is authored by experts representing the spectrum of urological subspecialties, further enhancing the value of this unique work.

E-FAST (extended focused assessment by sonograpy for trauma) represents the basic ultrasonographic approach to any trauma patient. Identification or exclusion of free fluid and air in the abdominal and thoracic cavities plays a pivotal role in deciding the immediate diagnostic and therapeutic path. Learning E-FAST is mandatory for all acute care surgeons and all physicians involved in trauma management. The structure of the book and its practical approach will make it an easy-to-consult and quick reference tool for beginners and a useful support for more experienced professionals.

Atrial fibrillation (AF) affects an estimated 1?2% of the population and is the most common cause of sustained cardiac arrhythmia. Critically, the number of patients developing AF is expected to double in the next five decades, leading to increased incidence of stroke, heart failure and other serious thromboembolic events. Essentials of Atrial Fibrillation is a timely investigation of current pharmaceutical trends, clinical guidelines, novel treatments, and ongoing pipeline developments, including ground-breaking advances in the use of novel oral anticoagulants.

This book covers new and exciting topics which have emerged in the area of autopsy recently, including the three different post-mortem CT-angiography systems currently available to practitioners in this field; a highly topical chapter on the role of genetic abnormalities in the handling of drugs within the body and how this can affect the interpretation of toxicological results in relation to how the drug may have caused or contributed to death; an update on the current classification and considerations related to deaths due to hanging; a review of injuries and fatalities caused by animals including post-mortem scavenging; an authoritative review of poisons and toxins from water and the life that inhabits it; and recent advances in knowledge in the use of entomology as an investigative tool as well as knowledge related to colonisation of cadavers by insects, animals and birds. Essentials of Autopsy Practice: Advances, Updates and Emerging Technologies is a multi-subject book, aimed at different grades of practitioners, from different practice areas, covering topics that are currently discussed and anticipated to be discussed in the field of autopsy practice over the next few years.

This title presents essential clinical knowledge in cardiac anesthesia in a practical, user-friendly format. Provides the key cardiac anesthesia information you need to know by authorities you trust. Uses a concise, user-friendly format that helps you locate the answers you need quickly. Features key points boxes in each chapter to help you quickly access the most crucial information. Includes annotated references that guide you to the most practical additional resources. Features a portable size and clinical emphasis that facilitates and enhances bedside patient care. Contains the authoritative guidance of larger reference books without the expense.

The general history and physical exam -- The abdominal exam -- The breast exam -- The cardiovascular exam -- The geriatric exam -- The gynecological exam -- The head and neck exam -- The lymphatic system and lymph node exam -- The musculoskeletal exam -- The neurological exam -- The obstetric exam -- The ophthalmological exam -- The pediatric exam -- The peripheral vascular exam -- The psychiatric exam -- The peripheral vascular exam -- The psychiatric exam -- The respiratory exam -- The urological exam -- The essentials of clinical pharmacology and toxicology -- The essentials of dermatology -- The essentials of emergency medicine -- The essentials of endocrinology -- The essentials of fluids, electrolytes, and acid/base disturbances -- The eseentials of general surgery -- The essentia